/clinical/,/clinical/pted/,/clinical/pted/hffy/,/clinical/pted/hffy/orthopedics/,

/clinical/pted/hffy/orthopedics/5209.hffy

20170102

page

100

UWHC,UWMF,

Clinical Hub,Patient Education,Health and Nutrition Facts For You,Orthopedics

A Patient’s Guide To Shoulder Arthroplasty (5209)

A Patient’s Guide To Shoulder Arthroplasty (5209) - Clinical Hub, Patient Education, Health and Nutrition Facts For You, Orthopedics

5209









A Patient’s Guide To
Shoulder Arthroplasty






1

























Highland Avenue





To go to the First Day Surgery Unit (608-265-8857), enter at the hospital
entrance. Follow the path to the D elevator. Take the D elevator to the 3rd floor and
turn left to the First Day Surgery Unit entrance.

This is the 2nd floor…
To get to the …

Cafeteria: H4/1 – H elevator to the 1st floor
ECG: Atrium elevator to the 4rd floor, Heart and Vascular Clinic
Outpatient X-Ray: 2nd floor just past the H elevators
Admissions: 2nd floor behind the information desk


2
Getting Ready

You will be scheduled for a pre-surgery physical exam in the Orthopedic Clinic.
You may also need to see a nurse in the anesthesia clinic. Expect your visit to last
2-3 hours.

Tell the healthcare provider at your pre-surgery physical exam visit if you are on
any blood thinners or have any implanted devices such as a pacemaker.

You may be asked to see your primary doctor before surgery. At the least, please
tell your doctor about your upcoming surgery.

Medicines

Do not take any nonsteroidal medicines such as aspirin, ibuprofen, Naproxen ,
Aleve , or Motrin for 1 week before surgery. You may take Tylenol if needed.

If you are on Coumadin (warfarin) or other blood thinners, you will need to stop
them before surgery. The healthcare provider who prescribed them will tell you
when to stop them.

If you are taking medicines for arthritis, you may need to stop these before surgery.

Planning Ahead

Many people who have a total joint replacement find it useful to plan ahead.
ξ Expect to be in the hospital for 1-2 days after your surgery.
ξ If you plan to go home or live alone, you should arrange for someone to stay
with you at least for a few days.
ξ Some people need further rehab or nursing home care. A social worker or nurse
case manager can work with you to arrange for these services.
ξ To prevent falls after surgery, prepare your home in advance. Watch out for:
o Loose rugs or loose carpets. Remove all of them.
o Pets that may run in your path.
o Water spills.
o Bare slippery floors.
o Long cords across floor, such as phone or fan cords.
o Ice on steps and porches, etc.


3

The Day before Surgery

ξ Because of constant changes in the schedule due to emergencies, the time of
your surgery will not be set until the day before. A nurse will call you at
your home or the number you gave us between 10:30 am and 3:00 pm on the
day before your surgery (on the Friday before a Monday surgery). You will
be told when to arrive, where to go, and answer questions that you may have.
Before this call, please review any special instructions that were given to
you. If you do not hear from us by 2:00 pm, please call (608) 265-8857
by 5:45 pm. Tell the nurse where you will be staying the night before
surgery.

ξ Try your best to have a restful night’s sleep. If you are coming from out of
town, you may wish to stay in Madison. A Housing Accommodations
Coordinator, (608) 263-0315, can provide you with a list of nearby motels
and arrange for your stay at a discount rate.

ξ The night before surgery eat a light supper. Stop eating solid food after
midnight the morning of surgery. It is ok to drink clear liquids such as water
or apple juice until 4 hours before surgery starts. If you are the first surgery
of the day, you may not drink after midnight.

ξ Clean the shoulder, armpit and neck with an antibacterial soap (Hibiclens )
for at least 10 minutes. Repeat this again the next morning using the
Hibiclens .

ξ Remove nail polish, make-up, and jewelry. Plan to leave any valuables at
home.



4
The Morning of Surgery

ξ With a sip of water, take only the medicines that you have been told to take.

ξ Arrive at the hospital by ____________. Take the D elevators to the 3rd
floor, turn left, and follow the signs to the First Day Surgery unit.

ξ Bring shoes that are easy to slip on, bottoms that are easy to pull on and a
shirt that buttons up the front or any loose fitting shirt large enough to go
over a bulky dressing.

ξ Bring along any inhalers or CPAP equipment, eye glasses, eye drops, hearing
aids, dentures, prostheses, or other special equipment that you will need. Be
sure these items are labeled and in a case, if appropriate. Please do not bring
bottles of medicines with you unless you have been told to do so.

ξ If you did not stop at the Admissions Department the day of your work-up
visit, plan to come to the hospital 15 – 20 minutes early, and stop at
Admissions to sign forms. If you are scheduled for surgery before 7:00 am, a
family member will need to go to Admissions and confirm your information
sometime after 7:00 am.

If you have diabetes, you will be given special instruction about your insulin
or oral medicines at your clinic visit.

A Note to Families

You can wait in the Surgical Waiting Area (C5/2) on the second floor. If you have
other family calling the hospital, please have them call patient information at
(608) 263-8590.

Some time during the day, take your parking pass to the main Information Desk to
have it stamped and to get one pass to be used during the patient’s stay.


5
After Surgery

Occupational Therapy
On the day after surgery, you will begin Occupational Therapy. The therapist will
come to your room. You will learn exercises and precautions (see below). These
exercises are designed to improve the strength and flexibility of your arm without
harming the surgical repair.

Ask your nurse for pain medicine 30 to 60 minutes before therapy. This often helps
decrease pain with exercises. Once home, the exercises should be done 3 times per
day.

Precautions
ξ Do not raise your operated arm.
ξ Do not rotate your arm outward or away from your body.
ξ Wear the sling at all times except when doing your exercises or unless your
doctor or therapist tells you otherwise.
ξ Keep the surgical dressing in place until it is removed at your 2-week clinic
visit.

Pain Relief
We want you to feel comfortable and able to do your exercises. Your doctor will
prescribe pain medicine for you. It may upset your stomach or cause constipation.
Eating something first will help. Or you may wish to take only half of the pill or
use over-the-counter drugs like Extra Strength Tylenol or ibuprofen.

Antibiotics
You also need to be extra careful not to get an infection in the joint. Taking
antibiotics before and after certain procedures can reduce your risk. Let your doctor
or dentist know that you have had a joint replacement. Plan to take antibiotics
before:
ξ Dental care, even routine cleaning
ξ Major or minor surgery
ξ Diagnostic procedures that could cause trauma to body tissues (colonoscopy,
endoscopy, some rectal exams or bladder exams)

The clinic staff can give you a “joint replacement card” that alerts doctors and
dentists of your needs. It can also be used to get through airports since you now
have metal that will be detected as you go through security.


6

Going Home

Incision Care
ξ Keep the dressing clean, dry and in place until you come back for your
follow up visit in 7-10 days.
ξ If swelling occurs, use an ice pack for 10-15 minutes until the area is numb.
ξ After the dressing is removed and the steri-strips fall off, it will be ok to
massage the scar, if it is no longer tender.

Activity
Common sense will tell you when you are over doing it. Too much activity can
interfere with progress. Moderate activity helps in your recovery. Too little
activity can delay the return of your strength and stamina. Keep doing the exercises
you have been taught. They are important to your recovery.

Sling
You will be wearing a sling to support your arm for 3-4 weeks. It may be removed
only when doing exercises and for bathing, when allowed.

Sleeping
You must sleep with your arm in the sling for 3 weeks. You may wish to place a
pillow under your arm to support both your arm and shoulder while in bed.

Bathing
Sponge bathe for 2-3 weeks to avoid getting the incision wet. At your first clinic
visit, the staples or stitches are removed. Two days after that, you will be able to
shower.

People who have had a joint replacement are at high risk for infections. Infection
of a joint implant can occur when bacteria enters the bloodstream. Before having
any dental, medical or surgical procedure, tell your doctor or dentist of your joint
replacement or metal implant. To prevent infection, you may need an antibiotic
before the procedure. If you have further questions, please call our office or your
primary care doctor.






7
Limits

Driving: Most people need to wait 6 weeks. Do not drive when taking any
prescribed pain pills. Your surgeon will let you know when you can drive.

Lifting: No lifting with your operative arm for 6-8 weeks.

Housework: Any activity you can do with one hand is allowed.

Sports: No sports for 3-6 months or per your doctor’s instructions.

Clinic Visits

You will be scheduled for a clinic visit 7-10 days after surgery. After the first visit
you will return again in 4-6 weeks. Other visits are based on your needs.

Therapy Exercises

Below are some of the exercises you might be taught. Please note that some of
them might not be right for you. Your doctor and Occupational Therapist will talk
with you about the best exercise program for you.

Upper Extremity
Perform pendulum exercises while
standing and bending at the waist. Support
your uninvolved arm on a table or chair
and allow your involved arm to hang
freely.

Pendulum Exercise 1

1. Keep your elbow straight throughout
the exercise.
2. Use your body to make clockwise
circles with your arm for one minute.
3. Reverse the direction and make
counterclockwise circles for one
minute.
4. Gradually increase the size of the circles.
Repeat __________times.


8




Pendulum Exercise 2

1. Keep your elbow straight throughout the exercise.
2. Use your body to swing your arm up toward your
head, and then back along the side of your body.
3. Repeat for one minute.
Repeat __________ times



Pendulum Exercise 3

1. Keep your elbow straight throughout the exercise.
2. Use your body to bring your arm across your chest, and then out to the side of
your body, in a side-to-side motion.
3. Repeat for one minute.

Repeat ____________ times.





Special instructions








9
Important Phone Numbers

Admissions
To speak with a financial counselor or verify insurance ... (608) 263-8770

Hospital Paging Operator ................................................... (608) 262-0486

Toll-Free ............................................................................. 1-800-323-8942

Housing Accommodations ................................................ (608) 263-0315

First Day Surgery Unit ...................................................... (608) 265-8857
Fax ..................................................................................... (608) 265-8858

Patient Information (for room number) ............................. (608) 263-8590

Outpatient Pharmacy (E5/236) .......................................... (608) 263-1280



















Your health care team may have given you this information as part of your care. If so, please use it and call if you
have any questions. If this information was not given to you as part of your care, please check with your doctor. This
is not medical advice. This is not to be used for diagnosis or treatment of any medical condition. Because each
person’s health needs are different, you should talk with your doctor or others on your health care team when using
this information. If you have an emergency, please call 911. Copyright © 12/2016 University of Wisconsin Hospitals
and Clinics Authority. All rights reserved. Produced by the Department of Nursing HF#5209.