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HF 7792

A Patient’s Guide to Shoulder Replacement at The American Center

This handout will tell you what to expect before and after shoulder replacement surgery. Please let us know if you have any questions. 

Before Surgery

To make sure you are in good health, you will need to have a pre-op visit within 30 days of surgery, a dental check up in the last six months, and maybe a visit with a specialist. 

Pre-Op visit: We will review the instructions for surgery at this visit. We will also go over your health history and do an exam. You will likely need lab work and an EKG. Tell us if you take blood thinners or have any implants such as a pacemaker. This visit will last one to two hours.

Dentist: Good dental hygiene helps to prevent infection in your new joint. Avoid routine dental care after surgery for at least three months. Address any dental concerns right away or we may postpone your surgery.

Specialists: You may also need to meet with other doctors before surgery such as a cardiologist, rheumatologist or lung doctor. We will let you know if you need this.

Nicotine

Nicotine slows down healing and has other harmful effects. If you use nicotine, we will ask you to quit for at least one month before surgery. We will also ask you not to use it while you’re healing. Some surgeons will test your blood to make sure you do not have nicotine in your system.

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.

  • Do not take herbal supplements for 1 week before surgery.

  • If you are on Coumadin® (warfarin) or other blood thinners, you will need to stop them before surgery. Ask your doctor how to taper off blood thinners.

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

  • If you have diabetes, we will talk with you about your insulin or oral medicines at your clinic visit.

Getting Ready

A nurse will call you at the phone number listed in your chart 1-2 business days before surgery. Make sure we have your correct contact numbers. The nurse will tell you when to arrive, where to go, and answer questions that you may have. Before this call, please write down any questions you have. If you don’t get a call from us by 4:00 pm, please call (608) 234-6698.

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. Our Guest Services staff can give you a list of nearby hotels and arrange for your stay at a discount rate. You may contact them at (608) 440-6242.

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

Shower with Hibiclens® (CHG) soap starting five days before, and the morning of surgery. Wash all your skin from the neck down. Avoid your genitals. Wash your shoulder well. Make sure the soap stays on your skin for at least 60 seconds. Do not shave the surgical site. If you shave your armpits, do not shave for three days before surgery.

Remove nail polish, make-up, and jewelry. Leave any items of value at home. 

Plan Ahead

If you live alone, have easy meals ready such as frozen dishes, cereal or sandwich makings so you do not have to cook.

Some people prefer to sit upright for sleeping so they move a special chair into their room.

Pick out loose button or zip up shirts to wear. Easy to pull on pants and shoes are helpful too.

You will be in the hospital for at least one night. You may need to stay longer if you have problems with nausea, pain control or balance. 

Arrange for someone to bring you home the next day. You should also arrange for someone to stay with you at least for a few days to help you out.

In some cases, home care may needed if you require more help. Please discuss this with your surgeon. A social worker or nurse case manager can work with you to arrange for this help. 

Rarely, patients need to go to a rehab center or nursing home. In most cases, this is not covered under Medicare unless you have other health problems. 

The Morning of Surgery

Take only your approved medicines with a sip of water.

Arrive at The American Center by _______. Enter through the main entrance by the valet parking. Check in on the first floor.

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.

Bring inhalers, CPAP, eye glasses, eye drops, hearing aids, dentures, prostheses, or other special aids that you will need. These items should be labeled and in a case, if needed. Please do not bring your medicines unless you were told to.

A Note to Families

You can wait in the Surgical Waiting Area on the 1st floor near the main entrance. If you have other family who will be calling, please have them call (608) 440-6400

Going Home

The day after surgery, an occupational therapist (OT) and/or physical therapist (PT) will visit you in your room. They will review safety measures for your shoulder, how to use the sling and show you how get out of bed safely. They may also give you simple exercises to do at home.

Therapy

You will start formal therapy soon after your surgery. If you have a therapist outside of UW Health, ask for a copy of the therapy protocol your doctor uses.

Safety Measures 

  • Do not raise or lift your surgical arm.

  • Do not rotate your arm outward or away from your body.

  • Always wear the sling except when doing your exercises, bathing or if your doctor or therapist tells you it is okay. In some cases, your surgeon will allow you to remove the sling when you are at rest sitting in a safe place.

  • Keep the dressing in place until it is removed at your post-op clinic visit.

Pain Relief

We may prescribe you a narcotic and an anti-inflammatory medicine. These can upset your stomach so take them with food. Use the Polar Care ice unit as needed for pain and swelling.

Other Medicines

We may prescribe you medicine to prevent blood clots for a short time.

Incision Care

Keep the dressing in place until you come back for your follow-up visit. Call the clinic if it starts to fall off or if blood oozes from it.

Activity Guidelines

Exercise (short term): Common sense will tell you when you are over doing it. Doing too much can cause pain and delay healing. Doing too little can delay the return of your strength. The right amount of activity can help you heal more quickly. Doing your home exercises will help you heal. 

Exercise (long term): You will have long term restrictions. Bench pressing weights as well as heavy, repetitive lifting over head is not allowed.

Driving: Do not drive when taking any prescribed pain pills. You cannot drive until you are out of your sling. 

Lifting: No lifting will be restricted for up to 3 months.

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

Sports: No sports for three to six months or until your doctor gives you the okay.

Bathing: The sticky plastic dressing can get wet in the shower. Once the dressing is removed at your post-op visit you can shower like normal. 

Antibiotics 

You need to be extra careful to prevent an infection in the new 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:

  • Dental procedures such as root canals and extractions (some surgeons require you to use antibiotics before routine cleanings). 

  • Procedures that could cause trauma to body tissues (colonoscopy, endoscopy, some rectal exams or bladder exams).

Clinic Visits After Surgery

You will be scheduled for a clinic visit seven to ten days after surgery. After the first visit you will return again in about six weeks, twelve weeks and then one year after surgery. We will see you sooner if you have concerns. 

Who to Call

Before Surgery & After Surgery Unit (608) 234-6698 

Guest Services (608) 440-6242

Hospital Paging Operator (608) 262-0486

Patient Information (for room number)(608) 440-6400

The American Center Pharmacy (608) 240-4265

Registration (to speak with a financial counselor or verify insurance)(608) 261-1600

Toll-Free 1-800-323-8942