Jerome V. Ciullo M.D.
Sports Medicine
Orthopaedic Surgery
5600 Crooks Road
Suite 103
Troy, Michigan 48098
(248) 813-0002
Fax: (248) 813-0007
Sports Medicine Center of Metro Detroit, P.C.
Surgical Information

WEIGHT LOSS: Excess body weight may be a major factor in contributing to, and also recovering from, a shoulder injury. Operations are designed to repair the injury, but some predictably do not hold up well due to excess body weight since this can cause repaired tissue to easily stretch apart. Excess body weight may actually cause enough traction to encourage bone spurs to reform after they are removed. If you had an operation that failed the first, second or even third time, it may be due to lifestyle factors such as excessive body weight or smoking. Each time the surgery is repeated, there is less tissue with which to work. Therefore, it is important to make changes, such as weight loss, in order to have a successful outcome from surgery. Certain operations that address combined pathology or joint instability cannot even be considered unless you are within 25 pounds of your ideal body weight. Your weight may not have been a problem prior to your injury, but decreasing body weight may be necessary to fully recover from your injury and heal from surgery.

SMOKING: Smoking is bad for your health. This is particularly true after surgery, where decreased oxygen in your system interferes with healing. In the AC joint of the shoulder, if bone is resected with the goal of being replaced by scar, in a low oxygen situation like smoking, asthma, or sleep apnea, the cells that are supposed to make scar make bone instead. You should not smoke or passive smoke, someone else smoking, for 4 to 6 weeks minimum following shoulder operation, as it could jeapordize your surgical result. It might be a good time to quit. You may want to discuss various medications or smoking cessation programs available through your local pharmacy or with your family doctor prior to surgery.

PAIN MEDICATION: No narcotics are issued through our office pre-operatively for chronic conditions. If you are on narcotics pre-op, get off of them before surgery. After surgery, narcotics can be used for 90 days, but if you need medication beyond that, you may have developed a tolerance and may be referred to a pain clinic to discontinue or to manage medication. With the use of post-operative pain pumps, circulating ice water devices, and occasional EMPI/TENS pain blocking devices, most patients need limited or no oral pain medication. The surgery is aimed at the mechanical cause of the pain, and if that is corrected, the pain should decrease and eventually be gone.

CRYOTHERAPY DEVICES: This devices replaces the use of ice packs following surgery. It is a cooler device that circulates cold water to the surgical site which will help reduce post-op pain and swelling. Some surgical facilities provide the device as insurance companies do not provide this as a benefit. Beaumont Hospital does not, and you will need to obtain this device and bring it with you for surgery. If you have one from a previous surgery, or can borrow one from someone that has used one in the past, please bring it with you on the day of surgery if your surgey is scheduled at Beaumont. Alert Medical is able to ship the unit to your home if necessary.

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