Anatomical Shoulder arthroplasty

Hemi arthroplasty (HA) or Total Shoulder Replacement (TSR)

 

On Ward:

  • 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.
 

2-6 weeks:

  • 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.
 

6 weeks:

  • 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.