Total Shoulder Replacement

By Dr. Gregory Drake

Preparation and recovery

Preparation For Surgery

Medical clearance from your primary care physician is required for all patients and must be completed at least 2 weeks before and no more than 30 days prior to surgery. If you are scheduled to see your physician less than 14 days prior to surgery, this may result in your surgery being delayed.

If you have any underlying cardiac conditions/history, you will also be required to obtain cardiac clearance prior to surgery.

A dental clearance is required for all patients and must be completed at least 4 weeks prior to surgery. If it is determined dental work will need to be completed surgery may need to be postponed.

We encourage you to have your pre-surgical testing done at the hospital prior to seeing your primary care physician, as many primary care offices are no longer performing blood work or EKG’s in their office.

Seven days prior to surgery, please do not take any anti-inflammatory (NSAID) medications (Celebrex, Ibuprofen, Aleve, Naprosyn, Advil, Aspirin, etc.) as this could result in increased bleeding during surgery. If you are on blood thinners these will also need to be stopped prior to surgery. Timing will need to be coordinated with the prescribing physician and Dr. Gregory Drake.

Do not eat or drink anything after midnight the day before surgery. You may take a small sip of water the morning of surgery to take your normal medications. This includes your blood pressure medicine, which in general should be taken. Consult your primary care doctor regarding medication and insulin instructions prior to surgery.

Post-operative pain medication will be sent to your pharmacy prior to the date of surgery. We recommend you pick up your prescriptions at least 2 days before surgery in the event there is a shortage of medication at your preferred pharmacy.

Post-Surgical Instructions:

There will be a big bulky dressing covering the shoulder which cannot be removed until the 3rd day after surgery. Once the bulky dressing is removed, you will see steri-strips resembling tape over the incision sites on your shoulder. You may now shower and get the steri-strips wet, however do not scrub the area and no soaking in a bath or hot tub. The steri-strips should remain intact on your shoulder until your post-operative appointment 10-14 days following surgery.

You must remain in your sling during the day and night for 2 weeks. The sling may be removed for showering; however, your elbow must remain at your side at all times. DO NOT open or close doors with the operative extremity.

Pendulum exercises may begin the day after your surgery and should be performed 5 times per day. In addition to pendulum exercises, you may perform gentle elbow flexion/extension and finger/wrist range of motion. (Refer to pendulum exercise link)

Physical therapy will begin 2 weeks post operatively.

Narcotic pain medications are prescribed if Tylenol is inadequate (Narcotic pain medications will cause constipation, so be proactive with stool softeners and laxatives). We will not refill pain medications over the weekend or after hours. Anticipate the need for medication refills.

You may drive as soon as it is comfortable to do so, which is usually after about two weeks following discharge from the hospital. You SHOULD NOT DRIVE while under the influence of pain medications.

Do not take NSAID medications (Ibuprofen, Naprosyn, etc.) or Cox-2 inhibitors (i.e. Celebrex) for 3 months following surgery unless approved by Dr. Gregory Drake.

Follow-Up:

Text Level Up Shoulder at (847-750-5255) or schedule online to book your routine postsurgical visit for 10-14 days after surgery with Dr. Gregory Drake’s physician assistant, Steve.

Patients will be seen by Steve (Dr. Gregory Drake’s PA) for the first two visits after surgery at 2 and 6 weeks. Dr. Gregory Drake will see patients at the 3 month postoperative appointment.

Please call Dr. Gregory Drake’s staff at Level Up Shoulder or your physician’s office immediately with any problems or go to the emergency room if you
develop:
Drainage and increased pain at the incision site
Fever greater than 101.5 degrees F
Swelling and tenderness in your legs, as this could be indicative of a blood clot

Precautions for Total Shoulder Replacement

Remain in your sling and allow the shoulder to rest and heal. There is
to be no active use of the shoulder. You may remove the sling to
perform elbow, hand and wrist exercises 5 times per day. DO NOT
externally rotate beyond neutral and DO NOT close doors or pull items
with the shoulder.