Arthroscopic Subacromial Decompression + Arthroscopic Excision of Distal Clavicle

(ACJT resection)

 

On Ward:

  • Wear sling as needed for rest and pain relief for approx. 2/52
  • Avoid axial loading through upper limb.
  • Exercises and advice sheet given by physio. i.e. active assisted exercises, GHJ – elevation and lateral rotation, posture, scapula setting and isometric cuff. No limitations in range of movement. Active exercises dependant on pain limitation and muscle control of movement.
  • Care of sling and washing techniques
  • Removal of sling for gentle exercises advised 4 times/day
  • May be limited by pain but can progress > 90° elevation in the first 2/52. No restrictions in ROM, dependant on active muscle control and pain.
  • Review by clinical specialist at 2-4/52 post-op in clinical specialist shoulder clinic at RSH, to be booked before discharged by ward staff.
 

2-6 weeks:

  • Progress as sub-acromial decompression. Patients may be have more pain at end range elevation than standard ASAD.
 

6 weeks plus:

  • Functional and sports specific rotator cuff and scapular training through range, to include proprioception.
 

Return to work: Sedentary 2-3 weeks (as pain allows). Physical 4-6 weeks (as pain allows).
Driving: 2 weeks (as pain and range allows) patient confirms they are able to drive safely.
Sport: Non contact 2-3 months. Contact 3-6months
Swimming: Gentle with modified stroke 3-4 weeks. Freestyle 8 weeks