Prior to your surgery, you will be provided with a surgery information pack which will include a letter detailing your admission, a consent form for you to sign and an estimate of costs. Please note this information may not be provided if an emergency procedure is needed or if you are directly admitted to hospital.
The administration staff at Dr Cutbush’s rooms are able to provide you with fees relating to Dr Cutbush and the assistant surgeon. There may also be costs relating to your anaesthetist and hospital stay including bed, theatre, prosthesis and incidentals. The contact details for these parties are included in the main letter in your surgery information pack.
Please keep in mind that our practice will give you the best possible care for you and your shoulder condition. It is not possible to do this through a bulk billing practice. We do not no gap or known gap initial surgical procedures.
Should you have any questions regarding the information in your pack please contact Dr Cutbush’s rooms.
Initially you will be given an admission time of 6:00am. You will be asked to ring Dr Cutbush’s office once the list has been finalised on the day prior to surgery. We will then be able to give you an admission time closer to the actual time of your operation.
We try to reduce the time spent waiting at the hospital, however, please remember this is a surgical procedure and there will be some waiting time involved prior to the operation.
Dr Cutbush operates at Brisbane Private hospital, and St Andrew's War Memorial Hospital. you will be advised which hospital your procedure and stay will be at.
Most shoulder operations involve an overnight stay in the hospital. This is because shoulder operations can be painful for the first night after surgery, and if you are in hospital, the nurses can administer strong pain relief if it’s needed, often it isn’t.
Almost all patients having an arthroscopic shoulder procedure are discharged the next day; usually, about 11am after seeing Dr Cutbush and the Physiotherapist. Patients having shoulder replacement surgery will often spend two nights in hospital following a shoulder replacement.
There are a few things that need to be done the morning following surgery, before you discharge from hospital.
On the ward
I will see you on the ward, usually, between 6:30 to 8:30am.
The nurses will change your dressings from the large suction dressing that we put on in theatre to collect any arthroscopic fluid (saline) that we use in your surgery that might come otherwise out from under the dressings.
One of the physiotherapists from Extend Therapy (dedicated shoulder physiotherapy group) will see you.
• The physiotherapist will stand you up and fit your sling with you standing to get the fit just right for you.
• They will take you through the exercise programme that we recommend for you after your particular surgery for the next 6 weeks and give you a handout with these exercises detailed.
• They will take you through the exercise programme that we recommend for you after your particular surgery for the next 6 weeks and give you a handout with these exercises detailed.
• If you need a reminder of how to do each exercise we have videos of the most common physiotherapy exercises that we recommend on the physiotherapy and the rehabilitation pages of this website.
• The physiotherapist will also explain how to get dressed and how to shower safely following your surgery.
The pharmacy will dispense and bring up the post-op medications that your anaesthetist has prescribed for post-op pain relief and your nurse will go through these medications to ensure you understand them.
Some patients will require an x-ray or scan post-op and we will usually get this performed by Brisbane Private Imaging before you are discharged. The nurses on the ward will make sure all of this happens in time for you to discharge from hospital by about 11am.
If you need to discharge earlier please alert the nurses on the ward as soon as you can so that they can help get you ready for discharge earlier.
• The Mupirocin Ointment (Bactroban or generic)* is applied to your nostrils twice daily, commencing 5 days prior to your surgery date.
• The Benzoyl peroxide 5% (Benzac AC 5%)* is the gel/cream that you are to apply to your shoulder 48 hours prior to your surgery. You need to leave this on your shoulder for 30 mins and then wash off, thoroughly. Please be mindful this is a peroxide and it will take the colour out of anything it comes into contact with.
• Chlorhexidine wipes – these are to be used after your shower at night time following the use of the benzoyl peroxide. There are multiple cloths in the packet, you are to use all of the wipes, all over your body ensuring you follow the directions on the back of the pack (it explains which areas to use the cloths so you don’t miss any parts).
These preparations are used to prevent and minimise any bacteria on the skin that may enter your body and cause complications with your surgery.
*You need to bring the Mupirocin Ointment (Bactroban or generic) and the Benzoyl peroxide 5% (Benzac AC 5%) to the hospital. You will be admitting to the hospital the night before your procedure. You will need to use these in hospital the night of your admission and the morning of your surgery.
For joint replacement surgery you either admit the day prior to surgery or if you live close you can admit on the morning of surgery. If you admit the day prior to surgery the nurses will give you another packet of Chlorhexidine wipes to use after you use the Benzoyl peroxide and have your shower.
Most incisions for arthroscopic surgery are 5mm or less and are used to insert the camera or to insert instruments to manipulate the tissues. The main working portals are larger and usually about 10mm in size, occasionally larger.
An arthroscopic procedure that involves the insertion of anchors or grafts such as a rotator cuff repair or a stabilisation procedure will require at least one working portal.
• A typical arthroscopic operation, such as an arthroscopic stabilisation procedure will require three to four incisions.
• An arthroscopic rotator cuff repair usually requires six incisions.
• A complex reconstruction such as for a massive rotator cuff tear utilising a graft to protect the repair may require as many as 12 incisions, sometimes more.
Following your procedure, prior to your discharge, Dr Cutbush will provide you with a post-operative folder. This includes a letter detailing your postoperative appointments and instructions. Please read this information carefully.
Dr Cutbush will also record a short video on his phone, taking you through what was involved in your procedure and what he did in your operation. As this is a large file, it will be sent to you via email. The email will contain a Dropbox link, which will allow you to download and view this video. If you have any difficulty viewing this video, please let the office know.
Once you are discharged from the hospital, you will not be able to drive yourself home, so you will need to organise alternative transport for yourself.
If you are needing to catch a taxi or public transport, it is not acceptable for you to travel unaccompanied. It is also important to make sure that you are not alone on the night following your procedure.
Should any problems or questions arise during your postoperative period please contact Dr Cutbush’s rooms.
It is very rare to develop blood clots following surgery on your shoulder. Blood clots or deep vein thromboses (DVT) are much more common following surgery on your hip or knee.
If you are concerned regarding the risk of you developing a blood clot please ring the office or ask Dr Cutbush.
The measures that are frequently taken to reduce the risk of blot clots forming include TED stockings, calf compression pumps, early mobilisation and medications such as heparin, clexane and aspirin.
Aspirin is a simple over the counter medication that many people can take that reduces the risk of blood clots forming.
The federal government has produced a brochure that discusses how to reduce the risk of blood clots. Blood clots – Reducing your risk
This is olecranon bursitis. Olecranon bursitis is a common benign condition that can be precipitated by wearing a sling. It is a collection of fluid and inflammatory tissue at the tip of the elbow. It is caused by friction of the elbow against the material of the sling.
It is common to develop swelling in your arm after shoulder surgery. Fluid collects around the shoulder after surgery as part of the body's normal response to the surgery.
The fluid tends to track under the skin with gravity and so it runs down into the arm. The pressure of the sling on the inside of the arm slows the progress of the fluid down the arm as it flows under the influence of gravity. It consequently tends to accumulate above the sling giving this characteristic appearance.
The swelling is entirely benign and will resolve once the shoulder has fully healed. It can take some months before the swelling entirely disappears but it does go away by itself and doesn't require you to do anything for it.
The appearance isn't due to local tissue trauma; instead, it is due to the blood and fluid flowing along tissue planes and following the pull of gravity. As the blood in the tissue is broken down and removed by the body, it will change colour as a real bruise would.
You don't need to do anything about it. The discolouration is entirely benign and will disappear within a couple of weeks of its own accord.
