Prima Medical Group

Raymond Bonneau, M.D. Orthopedic Surgeon

165 Rowland Way, Suite 100
Novato, CA 94945
(415) 898-4211
www.primamedgroup.com

Shoulder Arthroscopy Information

Introduction

You have been scheduled for a shoulder arthroscopy. This is now a very common type of shoulder surgery for problems such as impingement syndrome, rotator cuff tearing and shoulder instability.

Pre-Operative Instructions

You should not take Motrin, Advil, Naprosyn, or any other nonsteroidal anti-inflammatories for ten days prior to surgery. You should not take aspirin for ten days prior to surgery unless you have had any type of cardiac surgery including angioplasty, stent placement or bypass then you will need to continue taking aspirin, unless otherwise instructed by your cardiologist. You may eat or drink anything you’d like the night before the surgery, but you should have no solid food after midnight the day of your surgery. You may have clear liquids up until 4 hours before your surgery but limited to 4 ounces. Clear liquids are fluids that light can shine through, such as apple juice, coffee, tea and water. This does not include orange juice or milk. The best thing to have is a glass of apple juice or cranberry juice approximately 6 hours before the surgery to give you some glucose and fluids to get by until the time of surgery. Please make sure you drink nothing, not even water, beginning 4 hours before surgery.

Going to the Hospital

You should report to North Bay Regional Surgery Center or Novato Community Hospital 1 to 1 ½ hours prior to the scheduled time of your surgery. If your surgery is in the afternoon, it is often a good idea to call Same Day Surgery 4 hours before your surgery to determine whether or not the surgical schedule is running on time. The number at North Bay Regional Surgery Center is 415-209-2500. The number at Novato Community Hospital is 415-209-1558.

What to Wear

Loose clothing is best. You can wear underwear in surgery if you wish. Make sure you have a large button down shirt that will fit over the shoulder immobilizer which you will be placed in after your surgery.

Anesthesia

You will get to speak to your anesthesiologist prior to the surgery. For this type of shoulder surgery, we usually use a block, in which the anesthesiologist will give you an injection of a local just above the collar bone that will make the shoulder and arm numb for 24 hours. You will usually be sedated during the block and will not remember it. The block has two advantages. The first is that while most people still wish to be asleep, they do not have to have a deep general anesthetic as they feel no pain. Also, patients who wake up pain-free, and remain so for a period of time following the surgery, usually find the whole procedure, even weeks later, to be considerably less painful.

Surgery

The procedure itself takes 1 to 1 - 1/2 hours, and it is performed through 2 to 3 ¼ inch puncture wounds that are placed around the shoulder. Through one of the portals, an arthroscope is placed into the shoulder. The arthroscope is smaller than a pencil and is connected to a television camera. We use this to inspect the shoulder. The instruments come in through the other 1 to 2 puncture wounds. Dr. Bonneau make a video tape of your surgery with narration for you to watch afterwards. Most patients find this quite helpful in understanding what was done in their shoulder. The video tape shows the inside of your shoulder, the same image that Dr. Bonneau is seeing, and you certainly should plan to watch this tape in the first few days after your surgery.

Post-Surgery

After the surgery, you will wake up in the recovery room with your arm in a shoulder immobilizer, a strap like device around your abdoment with small straps to hold your wrist and upper arm. You will have a bandage on the upper arm and the shoulder itself will be quite numb. You will usually stay in the recovery room for approximately 30 to 60 minutes following which you’ll be in Surgical Daycare for an hour or so, until you feel well and can get up and use the bathroom independently.

At Home

The first day after the surgery, you may have more soreness than the day of the surgery itself. As the block wears off, please do not hesitate to take the pain medication as we certainly want you to be as comfortable as possible. You may see some bloody drainage on the bandage, which is arthroscopic fluid, mixed with blood leaking out. This is normal and you should not be concerned. If the bandage becomes quite soaked, however, you can certainly come to the office and we can change the dressing for your comfort. Each day after the first day, you will start to feel considerably better.

We would normally see you back in the office 2 to 4 days following your surgery, at which time we’ll remove the shoulder immobilizer and bandage, and then place your arm in a sling. After this point, you would be able to take a shower. I will explain to you how to begin a very gentle pendulum exercise program. On your first postoperative visit, we will remove your bandages and the small tape strips that hold the wounds closed. Band-Aids will the be placed. Following this you may remove the band-aids and take a shower. Gently dry the wounds and place new band-aids over the wound. We would suggest that you do not put any ointments, such as Neosporin, on the wounds and do not immerse your shoulder in water, such as in a bathtub or a hot tub for ten days following the surgery. At that point, the band-aids could then be discontinued.

You will again return to the office 10 days to 2 weeks post-operatively, at which time you’ll most likely not be using the sling. We would then instruct you in a more vigorous rope and pulley type exercise program.

By 6 to 8 weeks post-op, most patients are beginning to regain fairly normal motion in the shoulder, and you’ll progress with a strengthening program, which some patients do on their own in a gym setting, and some patients see a physical therapist to review this. It normally requires 3 to 4 months to gain good strength in the shoulder, and most patients report it takes 6 months before their shoulder feels back to normal.