Acromio clavicular Joint Reconstruction
On Ward:
- Sling for up to 4-6/52 for pain relief. Only to be removed for washing, dressing and exercise.
- Day 1 on ward. Active assisted elevation 0-60° in forward lean standing (assisted pendular elevation).
- Teach elbow, wrist and hand exercises.
- Care NOT to hitch scapula.
- Teach sling care and washing
- Active External Rotation as pain allows.
N.B. AVOID axial loading for 3/12. NO long lever strengthening 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.
2-6 weeks:
- Shoulder clinic review @ 6/52 to discuss progression then 6/12 review
- Aim for controlled quality early motion to 90° by 6/52, pain limiting. N.B. CARE not to impinge rotator cuff.
- Early Rotator Cuff rehabilitation after 4/52 – GHJ in neutral i.e. medial and lateral rotation – light resistance (30% MVC).
6-12 weeks:
- Regain FROM as able.
- No long lever strengthening > 3/12. Progress controlled rotator cuff and deltoid strengthening 6-12/52.
- Ensure scapular dynamic control through full range of movement.
- No heavy lifting before 3 months.
This is a general guide, please check specific post-op instructions before commencing rehabilitation.
Return to work: Sedentary 6 weeks (as pain allows). Physical 3-4 months (as guided by surgeon).
Driving: 6-8 weeks (as pain and range allows) patient confirms safety to drive.
Sport: Non contact 3 months. Contact 6-9 months (as guided by surgeon)
Swimming: Gentle with modified stroke 8-10 weeks. Freestyle 4-6 months
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
- Anatomical Shoulder arthroplasty – Hemi arthroplasty (HA) or Total Shoulder Replacement (TSR)
- 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