Dr Geoffrey Smith

Orthopaedic Surgeon

Shoulder and Elbow Surgery

Before Your Operation

Preparing for your operation is the first step in ensuring a speedy and smooth recovery.

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PAPERWORK
You will be provided with an admission pack containing information about the relevant hospital. There will be paperwork to complete and return to the hospital.

OUTCOME SCORES
I ask the majority of my patients to fill out surveys about their shoulder or elbow. Although some of the questions can seem silly or repetitive, they are used throughout the world. It is very important that you fill out these surveys. They let us know how you are doing and how we are doing. The initial survey is done at the time of booking surgery and gives us something to compare to later.

PREADMISSION CLINIC
Depending on your general health you may need to attend the preadmission clinic.

Medications

Most regular medications should be taken right up to and including the day of surgery.

However some medications may need to be ceased some time prior to surgery. Please discuss this with Dr Smith if you are unsure as to what you should do before your surgery.

Aspirin and anti-inflammatory agents

Cease 1 week preoperatively

Lipid lowering agents

Cease 1 day preoperatively and resume when stable and eating a full diet

HRT and Oral Contraceptives

In high risk surgery stop at least 4 weeks preop and during any period of postoperative immobility.

MAO Inhibitors

Discuss with Anaesthetist

Herbal Products

Stop 2 weeks preoperatively

Warfarin

Stop 5 days preoperatively after consultation with your GP and / or Specialist

Clopidogrel / Plavix

Stop 2 weeks preoperatively after consultation with your GP and / or specialist

Dabigatran (Pradaxa), Apixaban (Eliquis) and Rivaroxaban (Xarelto)

Last dose 48 hours prior to surgery

ACE Inhibitors

Don't take on the day of your operation

Smoking

Smoking increases the risks of the operation including those related to the anaesthetic and the surgery itself.

It is advisable to stop at least 2 weeks before the date of your operation. It is also preferable that you are off nicotine replacement, such as patches, before the operation. If you feel you can give up but need more time, it may be advisable to postpone the surgery to give you a chance to do so. Please discuss this with your General Practitioner and Dr Smith.

Rings and jewellery

Following surgery there may be some swelling of the arm or hand, so it is important to remove all rings on the arm to be operated prior to surgery.

If you are unable to remove these rings yourself, it is advisable to ask a jeweller to remove them for you in advance of the operation. Rings that have not been removed before surgery may need to be cut off and this may cause damage to precious items.

Skin care

You should take care in the two weeks before surgery to avoid scratches or wound in the area of the surgery.

These or active infections elsewhere in the body may result in the procedure needing to be postponed due to the increased risk of post surgical infections.

Specific issues for all shoulder surgery

SKIN CREAM

The risk of wound infection may be reduced by applying 5% to 10% Benzoyl Peroxide to the shoulder for two days prior to the day of surgery. This is an inexpensive gel that you can buy at a pharmacy. One product is Clearasil Ultra Acne Treatment Cream which contains 5% benzoyl peroxide. After showering, apply the gel to the shoulder area for the 2-3 days before surgery.

Specific issues for rotator cuff repairs

VITAMIN D

Vitamin D is important to bone health and studies also suggest that Vitamin D deficiency can be associated with poor healing after rotator cuff repair. Many patients are Vitamin D deficient. I recommend that you take Vitamin D (800 IU) for a month prior and for at least 12 weeks following rotator cuff repair surgery.

Ice Therapy

Ice after surgery is a very effective pain-relieving option that is free from side-effects.

Options for icing the shoulder include a bag of ice, a bag of peas, or a dedicated ice/ compression machine.

Many people find that the machine is most convenient, and the compression treatment has extra benefits. However, the machine may have an out-of-pocket expense. If you are interested in this type of device speak to Dr Smith’s team at least a week before surgery.

Preoperative Checklist

AS SOON AS YOU CAN

Order ice machine if you wish.
Vitamin D (start one month prior - rotator cuff repair surgery only).
Stop smoking.

A WEEK BEFORE SURGERY

Make sure that you know what to do with your medication. Admission documentation completed.
Get your scans together (x-rays, CT and MRI).

A FEW DAYS BEFORE SURGERY

Skin cream (Start 2-3 days pre-operatively before shoulder surgery).
Remove jewellery from affected side.

For all appointments and enquiries, please phone (02) 9587 4720 or email admin@drgeoffreysmith.com.au

St George SportsMed
Level 2, Suite 201
131 Princes Highway
Kogarah NSW 2217
(Entry from South St)

Getting Here

Monday to Friday
8:30am - 5:00pm

Fax: (02) 9587 6927