After the operation
The operations usually take around an hour and a half. Giving the anaesthetic takes about half an hour, and recovery before going back to the ward takes another half an hour to an hour.
You'll be taken to a recovery room or high-care unit until you're fully awake and the doctors feel that your general condition is stable. Then you'll be taken back to the ward.
Sometimes the local anaesthetic from the operation wears off in the middle of the night. This can cause disturbed sleep and tiredness. You'll probably be given painkillers before you go to sleep to make sure you'll be more comfortable. The drip and any drains are usually removed within 24 hours. After that you'll be able to start gently moving your arm again.
You'll usually be in hospital for 2–3 nights after your surgery. During this time medical, nursing, physiotherapy and occupational therapy staff will be involved in your care. You'll be given drugs after the operation to keep your arm as free from pain as possible. These may include:
- local anaesthetic
- 'patient-controlled analgesia' (PCA) – a system where you can control your own supply of painkiller going into a vein by pressing a button
- painkilling injections or tablets.
X-rays of your new joint will be taken during your stay in the hospital. Your arm will be in a sling or splint to protect it. If a tube was placed in the wound during the operation to allow blood to drain out, it's normally removed after 1–2 days (this isn't painful and is usually done on the ward).
It's important during the first few days after your surgery that you keep your hand and forearm raised (preferably above the level of your heart) and exercise your fingers on a regular basis. These exercises are simple to do and include making a full fist and stretching your fingers.
If you had a shoulder replacement you'll be in a sling to support your shoulder. You may need to keep this on for up to 4 weeks but different surgeons have different procedures.
After an elbow replacement, some surgeons use a plaster support (called a slab) behind the elbow to keep it in a fairly straight position for a few days. You won't be able to move your elbow in the slab, but once it's removed you can start moving your elbow again.
Physiotherapy and occupational therapy
Your physiotherapist will see you in hospital after the operation to help get you moving and advise you on exercises to strengthen your muscles. Either your physiotherapist or occupational therapist will tell you the dos and don'ts after your surgery. It's very important to follow this advice.
Because there are several different types of shoulder and elbow surgery, there's no single aftercare programme. Your post-op therapy will differ depending on the procedure you've had and also between different units and surgeons, so we can't recommend specific exercise plans. We suggest that you discuss with your surgeon what to expect after the operation.
Most people are ready to leave hospital within 2–3 days. How soon you can go home depends on how well the wound is healing and whether you'll be able to get about safely. After about 2 weeks you'll need to attend the outpatient department for a routine check-up to make sure your recovery is going well and your wound is healed. You may also be offered outpatient physiotherapy if your doctors feel that this will help your recovery.
If you stopped taking any of your regular medications or had to alter the dose before the operation, it's very important to talk to your rheumatologist or another healthcare professional for advice on when to start taking them again.