Some useful information
before your surgery
- Make sure your date and time of admission has been confirmed with my practice
- Make sure that you know at which hospital it will be performed
- Confirm that the admission authorization for the procedure has been obtained from your medical aid, either by yourself or the relevant hospital. It remains your duty to make sure about the pre-operative authorization as you are the client of your specific medical insurer
- Please make sure that I know about your current chronic medication and especially if you are on an anti-coagulant medication (blood thinning medication)
- Please don’t eat or drink for 6 hours before your admission
- If it is a day case procedure, please do not drive home yourself after surgery as the anesthetic will influence your driving capability
- Make sure about the possible recovery period after surgery e.g: time off duty or sport
The day of surgery:
- You will be allocated to a bed by the hospital personnel
- Make sure that the nursing staff are aware of all your allergies and chronic medications
- Confirm that they have the correct side, left or right , and you will be asked to mark the relevant side with a marker pen in hospital
- You will have time to see the anesthetist and ask all relevant questions regarding the procedure and possible costs .Please ask about the affects of the nerve block they will administer during your operation to assist in pain management after surgery as we strive to do these procedure with no or as little as possible pain after surgery
Possible risks and complications
after shoulder and knee arthroscopic procedures:
All surgical procedures are associated with a degree of risk. My team of health providers will do everything possible to minimize the risks and complications. I will discuss the risks and complications of the procedure, as well as alternative treatments before surgery with you. This is part of the consent process.
Below is a list of some risks and complications associated with common shoulder surgical operations, but these may differ depending on the exact type of surgery you are having. Do not be afraid to ask me what the possible complication rates are for a procedure (even the best surgeons unfortunately do get complications!)
PAIN
Which happens with every operation. My healthcare team will try to reduce your pain. An intra-operative pain block by the anesthetist will reduce the pain after surgery to almost zero for the first 12 to 16 hrs. We will give you medication to control the pain and it is important that you take it as prescribed for the first 48 hours, so you can move about as advised Complex Regional Pain Syndrome (CRPS) is an extremely rare complication of shoulder surgery and associated with long-term disabling pain that can be difficult to treat, however this is extremely rare.
STIFFNESS
After shoulder surgery is not uncommon and can occur in approximately 10% of people. It is known as a ‘Post-operative frozen shoulder. It is more common after rotator cuff repairs, diabetics, and older people. In most cases it improves with physiotherapy, but sometimes a steroid injection, hidrodilatation or surgery (MUA or capsular release) is required. Almost all stiffness is gone by one year after surgery.
NERVE INJURY
Nerve Injury is rare (<0.5%) with most shoulder operations, but some larger operations have a higher risk, such as revision shoulder replacements, Laterjet procedure and complex fracture surgery
BLEEDING
During or after surgery (<1%). It is extremely unusual to need a blood transfusion.
INFECTION
This is rare, especially with arthroscopic surgery. Generally, many procedures are undertaken during your surgery to minimize the infection risk such as special clean air theatres, sterile environments, prophylactic antibiotics, etc. After your operation, you should let your surgeon know if you get a temperature, notice pus in your wound, or if your wound becomes red, sore, or painful. An infection usually settles with antibiotics but occasionally the wound needs to be drained or you may need another operation.
LOW GRADE
Low grade infections are more common after shoulder surgery than other joints. It is characterized by a post-op frozen shoulder that does not improve with usual treatments. The incidence can range from 0.5 to 10%. It is more common in young, sporty males with acne.
UNSIGHTLY SCARRING
Unsightly scarring of the skin affects <1% of patients. Most surgical scars have disappeared to a thin pale line by one year after surgery. Before then they can look a bit red. If you are concerned about your scar, you must discuss it with your surgeon, as there are many treatments to improve scar healing (such as Bio-oils, Silicone gels, massage, etc.). Arthroscopy scars are usually very small and neat.
BLOOD CLOTS
The risk of getting a blood clot in your leg (DVT) or lung (PE) are rare and more common after surgery on your leg. The overall published rate for shoulder surgery is 0.2%. The risk is higher in people who are overweight, older age, hormone therapy (e.g: HRT and contraceptive pill) and smoking. The risk is also higher if surgery lasts more than 150 minutes. In high-risk patients we usually use an anticoagulant to try reduce the risk of clots. Please inform me should you have a familial tendency or had previous blood clots
ANAESTHETIC RISKS
This will be discussed with you by the anesthetist
Warning symptoms and signs after surgery
Please contact us or your GP should you experience the following:
- Fever and night sweats
- Redness and swelling of the specific operated area
- Chronic discharge or pus draining from the wounds
- Pain not responding to medication or severe side effects of the pain medication
- Pain blocks lasting longer than 24 hours
- Warning signs of a possible blood clot in the calf, especially after a knee arthroscopy are the following:
- Swollen calf
- Redness and warmth in the calf
- Inability to put weight on the leg
- Unable to retract the toes and foot upwards
- Very tender calf or thigh muscle on palpation
Please do not hesitate to
discuss any of your concerns with us