LIVING WITH A NEW SHOULDER

LIVING WITH A NEW SHOULDER

DePuy Synthes Joint Reconstruction shoulder implants DePuy Synthes Joint Reconstruction, the manufacturer of your implant, pioneered the orthopaedics industry 100 years ago, and remains a leader today. DePuy Synthes Joint Reconstruction continues to advance the art and science of shoulder replacement with innovative solutions to help improve lives of patients around the world. Surgery You and your surgeon will meet before surgery to check on your medical condition and discuss your concerns. It is essential that you tell your surgeon about any medications or supplements you are taking. Compile a list of all the medications and dosages, including nonprescription medicines and supplements. In preparation for surgery, you may be asked to: lose weight quit smoking discontinue certain medications temporarily not schedule urologic or dental procedures (teeth cleaning, cavity repairs or oral surgery) within two weeks of your shoulder surgery In-hospital recovery Here s what to expect during your hospital stay. Immediately after surgery You may have a drainage tube coming out through the bandages and attached to a portable container. This system applies continuous, gentle suction to remove fluid in the wound. 2

Cold compresses may be applied for up to two days. To prevent nausea, you will be given only ice chips or sips of water and soft drinks immediately after surgery. On the first day after surgery, you will begin drinking and eating normally as directed by your surgeon. An immobilizer or splint protects and positions your shoulder as you heal. Keeping a small pillow or folded blanket under your elbow while sitting or lying down will prevent strain in the operated area. Later on the day of surgery the surgeon will check on the operated shoulder, perhaps removing the sling and gently moving your arm. The surgeon will give you instructions on how much you can or should move your arm. 3

A trapeze bar attached to the bed will help you sit up and move. Only use your nonoperated arm to pull yourself up. Don t turn on or move your operated shoulder until the surgeon says you may. The nurse will help you find comfortable positions. On the first or second day after surgery Drainage is usually removed and your bandages changed. The nurses will encourage you to stand, walk and do simple exercises. Your doctor will explain how to do special stretching and range-of-motion exercises. You will be encouraged to use your operated arm for normal activities, such as eating and drinking, brushing your teeth, or shaving. Before hospital discharge You will receive instructions for your at-home recovery, including how to use your shoulder sling, change your bandage and bathe or shower. The surgical team will give you the necessary instructions to continue exercises at home. The surgeon will write prescriptions for pain medication and schedule a follow-up appointment. At-home recovery Here s what you can expect during your recovery at home after you have been discharged from the hospital. Feel free to take it easy for the first few days after you return home. 4

Ask a family member or friend to be available to help with daily activities, especially during the first week at home. Feeling frustrated is a normal reaction, but the frustrations soon pass. Some discomfort is normal as your shoulder heals. However, it is unusual to use pain medication for more than five to seven days after surgery. Call your surgeon before your medicine runs out if you need to have your pain prescription refilled. Contact your surgeon if you notice: Drainage and/or foul odor from the incision Fever (101 degrees F or 38 degree C) for two days Increased swelling, tenderness, redness and/or pain Contact your family doctor if you develop: Cold, fever or sore throat Breathing problems Heart problems Other physical difficulties that concern you Your surgeon will usually schedule regular follow-up appointments even if you are not having any problems. Important safety information As with any medical treatment, individual results may vary. The performance of shoulder replacements depends on age, weight, activity level and other factors. There are potential risks, and recovery takes time. People with conditions limiting rehabilitation should not have this surgery. Only an orthopaedic surgeon can tell if shoulder replacement is right for you. 5

Special instructions Always tell your dentist or doctors that you have an implant. If you are to have dental work performed, please call your surgeon prior to having this work done. Your surgeon will most likely prescribe an antibiotic for you. Antibiotics must be used before and after any medical or dental procedure - a precaution that must be taken for the rest of your life. Resuming activities Check with your orthopaedic surgeon for advice on recommended activities. With the help of a family member or friend, do the exercises you learned in the hospital four to six times daily as directed by your doctor. The exercises gradually increase the movement of your shoulder, so it is important to do them as scheduled. Do not skip your stretching exercises. Rest in bed as necessary. Be sure to rest on your back. For the first week, sit in the bathtub and wash. Bathe your armpit with warm water and dry the area thoroughly. Your surgeon will tell you when you can shower, typically five or six days after surgery. Use only roll-on or stick deodorants. Avoid spray deodorants because they may irritate the incision. Since recovery is different for each person, your surgeon will inform you when you can resume activities such as returning to work and driving. 6

You are encouraged to return to normal sleeping and eating patterns as soon as possible. Being as active as possible helps control muscle tone and weight. Just remember to follow your surgeon s advice about exercise and activities. Overworking your shoulder could injure healing tissue. Avoid stressing your shoulder, especially in ways that might cause falls or collisions. Your surgeon can discuss your progress with you during follow-up visits. Shoulder rehabilitation process Postoperative rehabilitation plays a vital role in preparing to resume life with a new shoulder. You will want to cooperate, follow your surgeon s instructions and work hard to achieve the best outcome. Rehabilitation Stretching and normal daily activities often begin the day of surgery. Pain medication may be taken before your therapy as you request. At first a physical therapist will gently move your arm and shoulder through various positions as you relax. These passive exercises help prevent stiffness as you gradually regain shoulder motion. You will also tighten the muscles of your hand and arm by flexing your hand, wrist and elbow. The physical therapist will teach you the safest ways to get into and out of bed or a chair, and on and off the toilet. Your therapist will track your daily progress and keep your surgeon informed. 7

The post operative rehabilitation program is divided into two phases. Phase 1 Stretching The following exercises are examples of stretching exercises. Your surgical team will give you detailed instructions on which stretching exercises to do and how often you should do them. Stretching exercises help you regain as much shoulder movement as possible following surgery. These exercises demonstrate the stretching of the left shoulder. Phase 1-1: Pendulum Exercise Phase 1-2: Abduction 8

Phase 1-3: External Rotation Phase 1-4: Flexion Phase 1-5: Extension 9

Phase 1-6: Internal Rotation Phase 1-7: Pulley Phase 1-8: Overhead Bar 10

Phase 1-9a: Wall Walking (both arms) Phase 1-9b: Wall Walking (both arms) Phase 1-10: Door Hanging 11

Phase 1-11: Posterior Stretching Phase 2 Strengthening Strengthening exercises are used to regain strength of all muscles around your shoulder. These exercises are done only when instructed by your surgeon. You will begin strengthening exercises only after you have achieved as much movement as possible. Ordinarily, people don t start strengthening exercises until six to 12 weeks after surgery. Do not start these, or any other, exercises until you have the necessary supplies and instructions from your surgeon, including which exercises to perform and how often. These exercises demonstrate the strengthening of the left shoulder. 45 Phase 2-1: External Rotation 12

45 Phase 2-2: Abduction Phase 2-3: Extension 13

45 Phase 2-4: Internal Rotation Phase 2-5: Flexion 14

Phase 2-6: Wall Push-Up Phase 2-7: Knee Push-Up Phase 2-8: Regular Push-Up 15

Phase 2-9: Shoulder Shrug Phase 2-10: Shoulder Press-Up Phase 2-11: Pulley Strengthening 16

Phase 2-12: Anterior Deltoid Strengthening 17

Answers to your questions How long will I be in the hospital? Your surgeon will determine the length of your hospital stay. When will I be able to move my shoulder? You will be instructed in the active use of your arm for the gentle activities of daily living on the first postoperative day. What do I wear? You should be able to wear regular clothes after surgery, i.e., a loose fitting, buttoned shirt and comfortable trousers/skirt. Women may find a bra uncomfortable in the early days. Will I need to do anything special when I go home? You will need to perform the special rehabilitation exercise program as directed by your surgeon. When can I return to work? You may return to work when your surgeon gives the OK. When can I drive? Your surgeon will let you know when you can start driving again. Will I have a scar? Yes, there will be a scar, however, the formation of scars varies from patient to patient. How can I protect my new shoulder? Follow your surgeon s instructions. Stay healthy and physically active without straining your shoulder. Avoid lifting, pushing or pulling heavy objects. Talk to your surgeon before starting any sport or activity that might affect your new shoulder. 18

How long will my new shoulder last? Many factors affect the life of a typical shoulder implant, including: Your preoperative physical condition and activity level The design and materials of the shoulder implants Your willingness to undertake rehabilitation according to your surgeon s directions I live by myself. Whom can I turn to for help during recovery and rehabilitation? You will likely need assistance with your daily activities for several days to a few weeks following your shoulder replacement surgery. If you live alone, speak with your surgeon about being admitted to a rehabilitation facility for at least a few days following your surgery so you can get the assistance you need. Resources The website links below have additional information on treatment options for shoulder pain. www.depuysynthes.com www.shoulderpainsolutions.com www.strengthforcaring.com The Strength for Caring network can help you connect and share your experiences with others. Whether you are coping with surgery, or caring for a patient following surgery, strength for caring offers resources to assist you. 19

To learn more about shoulder replacement surgery, visit www.depuysynthes.com DePuy Orthopaedics, Inc. 700 Orthopaedic Drive Warsaw, IN 46582 Telephone: (800) 366-8143 Fax: (800) 669-2530 www.depuysynthes.com DePuy Synthes Joint Reconstruction, a division of DOI 2013 0612-80-510 (Rev. 2) 5M 1113