Download Arthroscopic Shoulder Surgery


It is normal to have swelling and discomfort after surgery that may
last anywhere from days to a week or even slightly longer.

You will stay in the hospital for a total of 3 days.

Following your surgery you will be provided with narcotic
medications. These medications are designed to help with, but not
take away completely, the post-operative pain. DO NOT TAKE
MORE OF THE PAIN MEDICATION !!!!!!!!!!!!!!!!!!!!!!!!
**If you feel as though the pain is unbearable despite taking the pain
medications AS PRESCRIBED, then call the nurse practitioner, Aimee
Mulkern at (617) 643-0356 to discuss other options.
If it is during non-office hours or on the weekends/holidays, call the
orthopaedic resident on call for Dr. Holovacs by dialing (617) 726-2000.
That physician can answer questions and advise you how to proceed with
pain medication management.
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
Do not drive or operate heavy machinery while taking narcotic
medications.
 *Constipation
 Itching
 Nausea
*To help avoid constipation, drink plenty of water in addition to
taking an over the counter stool softener such as Colace or Senekot, if
you so desire.
Apply ice bags or use the cryocuff you were given to control swelling.
You may use the ice continuously for the first 48 hours but make sure
that your skin is well protected to prevent skin breakdown.
To protect your skin put a thin towel or T-shirt next to your skin (and
the ice on top of the shirt/towel).
Check your skin frequently during this time to ensure adequate
protection (to make sure that the shirt or towel has not moved
rendering the skin exposed).
Icing is most important in the first 48 hours, although many people find
continuing it lessens their postoperative pain. Ice should be applied 20-30
minutes at a time as needed.
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It is very important that you resume taking all of the medications
that you were taking prior to your surgery, IMMEDIATELY
FOLLOWING YOUR SURGERY.
Individuals who take a daily Aspirin for cardiac reasons and who
were instructed to stop it for 7-10 days prior to their surgery
should absolutely resume taking the Aspirin immediately after
their surgery.
 Your bandages should remain in place for at least 2-3 days
after your surgery (unless it becomes wet or too tight from
swelling).
 After 2-3 days have elapsed, you may remove the bandage
and throw it away.
 You may shower after you remove the post-operative
dressing.
 You must keep your incision dry for the first 7 days with
a watertight dressing.
with any signs/symptoms of infection at the incision site(s) such as:
o Redness
o Swelling
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o Warmth
o Drainage
o As well as if you experience any fever, chills, and/or pain that is
not relieved by the pain medications.
you should call the hospital at (617) 726-2000 and ask for the
orthopaedic resident on call to be paged.
 If you have not already done so, please make your follow-up
appointment for 7-10 days after your surgery date.
 Following surgery, you will be prescribed a regimen of physical
therapy.
 You will begin physical therapy the day after your surgery
while in the hospital.
 This will consist of a therapist moving your arm for you as well
as them teaching you exercises to be done at home following
discharge from the hospital.
 Aimee Mulkern, NP will provide you with specific physical
therapy instructions at your first post-operative visit (7-10 days
after your surgery).
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Now that you have an artificial joint, you will need to take antibiotics before
any future dental and/or surgical procedures FOR THE REST OF YOUR
LIFE. We have provided you with our recommendations for this antibiotic
prophylaxis in a letter format (attached to this document). We ask that you
please give one copy to your dentist and one copy to your Primary Care
Doctor.
 Make sure that you have established supports prior to your
surgery so that you will have people who can assist you during
your recovery phase.
 Abstain from drinking alcoholic beverages and smoking.
 Drink plenty of water and eat a regular diet.
 Plan to take AT LEAST a few days to a week off from work.
Should you have any other questions regarding your post-operative
instructions, feel free to contact us at (617) 726-0298.
Thomas F. Holovacs, MD
Aimee Mulkern, NP
Christine O’Connor
Karen Kelly
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Thomas F. Holovacs, MD
Harvard Shoulder Service
Massachusetts General Hospital
55 Fruit Street, Yawkey Center, Suite 3G-3200
Boston, MA 02114
(617) 726-0298 (phone)
(617) 726-0620(fax)
Dear Patient,
You have had surgery to replace one of your joints with a metal prosthesis or an allograft
(donor bone). From now on, you must take oral antibiotics before any dental work
(including routine cleanings), upper respiratory tract procedures such as endoscopy, or
before any genitourinary/gastrointestinal procedures such as a colonoscopy. These
procedures are a potential source of infection. If you develop an infection, it could
spread to your operative area and cause complications.
Please present this letter to your medical doctor and dentist, so he or she can prescribe the
appropriate medications for you. The following information is recommended by the
American Heart, Dental, and Orthopaedic Associations:
Standard General Prophylactic:
Amoxicillin
Adults: 500 mg
Take 4 capsules (2 grams) orally one hour
before the procedure
If allergic to Penicillin:
Clindamycin
Adults: 300 mg
Take 2 capsules (600 mg) orally one hour
before the procedure
Cephalexin
Adults: 500 mg
Take 4 capsules (2 grams) orally one hour
before the procedure
Azithromycin
Adults: 250 mg
Take 2 capsules (500 mg) orally one hour
before the procedure
NOTE: Cephalosporins should not be used if you have ever developed an immediate
hypersensitivity reaction (i.e. hives, swelling, severe itching, difficulty breathing) to
Penicillin.
Please feel free to contact our office with any questions or concerns.
Thomas Holovacs, MD
Harvard Shoulder Service
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Thomas F. Holovacs, MD
Harvard Shoulder Service
Massachusetts General Hospital
55 Fruit Street, Yawkey Center, Suite 3G-3200
Boston, MA 02114
(617) 726-0298 (phone)
(617) 726-0620(fax)
Dear Patient,
You have had surgery to replace one of your joints with a metal prosthesis or an allograft
(donor bone). From now on, you must take oral antibiotics before any dental work
(including routine cleanings), upper respiratory tract procedures such as endoscopy, or
before any genitourinary/gastrointestinal procedures such as a colonoscopy. These
procedures are a potential source of infection. If you develop an infection, it could
spread to your operative area and cause complications.
Please present this letter to your medical doctor and dentist, so he or she can prescribe the
appropriate medications for you. The following information is recommended by the
American Heart, Dental, and Orthopaedic Associations:
Standard General Prophylactic:
Amoxicillin
Adults: 500 mg
Take 4 capsules (2 grams) orally one hour
before the procedure
If allergic to Penicillin:
Clindamycin
Adults: 300 mg
Take 2 capsules (600 mg) orally one hour
before the procedure
Cephalexin
Adults: 500 mg
Take 4 capsules (2 grams) orally one hour
before the procedure
Azithromycin
Adults: 250 mg
Take 2 capsules (500 mg) orally one hour
before the procedure
NOTE: Cephalosporins should not be used if you have ever developed an immediate
hypersensitivity reaction (i.e. hives, swelling, severe itching, difficulty breathing) to
Penicillin.
Please feel free to contact our office with any questions or concerns.
Thomas Holovacs, MD
Harvard Shoulder Service
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