Anatomical Shoulder arthroplasty
Hemi arthroplasty (HA) or Total Shoulder Replacement (TSR)
- Sling for 2/52. Can remove sling at night after 2/52 if comfortable.
- Day 1 on ward – commence active-assisted elevation, external rotation to neutral, short lever abduction and elevation in internal rotation. Can commence active external rotation as pain allows. Exercises may be taught to relative as appropriate.
- Maintenance elbow, wrist, hand and neck exercises, sling care + washing techniques.
- Scapula setting and posture
N.B. AVOID axial loading for 3/12.
- Review by clinical specialist at 2/52 post-op in clinical specialist shoulder clinic at RSH, to be booked before discharged by ward staff.
- 3/52. Active ROM can be commenced in all movement planes. Hydrotherapy or use of gentle stretches, accessory movements or soft tissue mobilisations to increase ROM.
- Commence early static cuff exercises at week 2 and progress light rotator cuff and deltoid strength through range 4-6/52 as able.
- Clinic review at 6/52, 6/12 and 1 year.
- If all well, full active exercises as tolerated. Progress overall strength of rotator cuff and deltiod and concentrate on functional rehabilitation.
Aim to regain pre-operative movement by 12 weeks.
Return to work: Sedentary 6 weeks (as pain allows). Modified Physical 3-4 months (as guided by surgeon).
Driving: 6 weeks (as pain and range allows). Patient confirms safety to drive.
Sport: 3-4 months dependent on activity (as guided by surgeon)
Swimming: Gentle with modified stroke 6 weeks onwards.
Click on the links below to read the guidelines for individual procedures:
- Arthroscopic Sub-Acromial Decompression
- Rotator Cuff Repair
- Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle (ACJt resection)
- Anterior Stabilisation (open or arthroscopic)
- SLAP repair – arthroscopic
- Acromio Clavicular Joint Reconstruction
- Arthroscopic Capsular Release and MUA of Frozen Shoulder
- ORIF Clavicle / Hook Plate Clavicle
- ORIF proximal humeral fractures – (Proximal Humeral Locking Plate)
- ORTHO SPACE (In space Implantation)
- Physiotherapy Protocol for REVERSE Total Shoulder Replacement