Discharge Instructions: Knee Arthroscopy

Shane K. Woolf, MD Associate Professor of Arthroscopy, Sports Medicine, and Shoulder Reconstruction Chief, Sports Medicine Medical University of South Carolina

Administrative Assistant: M. Annie Justiss Office: (843) 792-1081 Fax: (843) 792-3674

Patient Instructions After Shoulder Rotator Cuff Surgery

Diet: - Resume your regular (high fiber) diet as tolerated. Use a stool softener if needed. Drink water.

Medications: - ______take ______tablets every 4-6 hours, as needed for pain (pain killer). - ______take ______tablets every _____ hours (additional pain killer). - ______is a non-narcotic pain medication. You may take up to ______mg ______time(s) per day for ______days with food. DO NOT take nonsteroidal anti-inflammatory medicines (eg Advil, Motrin, Aleve, Celebrex, etc) with Aspirin or other similar medications. - Resume preoperative medications unless instructed otherwise.

Dressing Care: - Keep dressing clean and dry. DO NOT remove the sutures. - You may expect some light bloody drainage through the dressing from the fluid that is placed into the shoulder during arthroscopy. - Remove the dressing on the 3rd day after surgery. If the incisions are still moist, place a Band- Aid over the site until dry. If drainage continues contact your physician. - Keep incisions dry for at least 3 days. After 3 days you may shower, but do not soak the incisions until discussed with your physician. When you shower, do not rub the incisions. Simply allow the water to wash over the site, and then pat dry.

Activity: - Rest and minimize activity after surgery. - Apply ICE for 20-30 minutes every 2 hours when awake (or use a cooling pack as directed) for the first 2-3 days. - If prescribed, call your physical therapist to arrange the first visit 3-5 days after surgery. - DO NOT resume use of regular exercise equipment until cleared by your physician. - A sling will be provided prior to discharge. Remove the sling 5 times each day to perform motion exercises. Continue to use the sling as long as your surgeon instructs, including during sleep. The sling should only be removed for exercises, clothing changes, or while showering. Keep a clean pad in your armpit to prevent excessive sweating when in the sling. - Active motion of the elbow, wrist, and hand are permitted immediately. Active shoulder overhead reaching and lifting under your own power are NOT permitted yet! You may use the operated arm after surgery only for activities of daily living that do not require it to leave the side of the body (eg eating, drinking, bathing, writing, computer use, etc.) - Five times each day you should perform Passive and Assisted Range of Motion exercises. For example, forward elevation and external rotation exercises as shown below should be performed with the non-operated arm used as the “helper arm” controlling the motion of the operated arm. The operated arm should remain relaxed at all times. Twenty of each exercise should be performed five times per day. - Overhead Reach is helping to lift your operated arm up as high as it will go. Stretching is the GOAL! To perform overhead reach, lie flat on your back, RELAX, grasp the wrist of your operated shoulder with the helper hand. Using the power of your helper arm, bring the operated arm up to 90 degrees (straight up from the ground). Start by holding it there for 10 seconds. After the pain improves, you should try to hold it for 30 seconds. Breathe slowly and deeply while the arm is moved. Repeat this stretch 20 times, trying to move the arm up a little higher each time.

- External Rotation is turning the arm out to the side while your elbow stays close to your body. External rotation is best performed while lying on your back. Hold a cane, yard stick, broom handle, or dowel in both hands. Bend both elbows to a right angle (facing straight up). Use gentle, steady force from your helper arm to rotate the hand of your operated shoulder out away from your body. Continue the rotation to 30 degrees away from the chest holding it there for 10 seconds (***if your subscapularis tendon was repaired, turn the arm to neutral only, so your hand faces just straight forward from the chest). Repeat this exercise 20 times.

- Pendulum swings – dangle arm while seated and use other arm to move/swing the operated side.

Follow up: - You should have a follow-up appointment in ______. If you do not already have one scheduled, call (843) 876-0111 to make an appointment. - Notify the doctor if you have fever over 101.5ºF, excessive wound drainage, severe calf tenderness, numbness in the leg, increasing pain, or any urgent concerns. - You can reach the doctor or his staff 24 hours per day, seven days a week, by calling (843) 792- 2123 if you have an urgent question or concern. - For medical emergencies call 911.

Specific Instructions: