Reverse Shoulder Replacement

Severe cuff arthropathy, shoulder arthritis (certain indications), revision surgery

	In Patient
Day 1	Polysling with body belt fitted in theatre Finger, wrist and elbow movements Cold compression Drain removal after 24 hours
Week 1	Body belt removed Axillary hygiene is taught The Subscapularis has not been repaired and therefore protection regarding IR and ER beyond neutral is not required Handing gripping exercise Pendular exercises Passive flexion, abduction, internal and external rotation Scapular setting and posture correction Discharge when safe, usually 3 days post-op Keep sling for 6 weeks May perform ADL below shoulder level, such as eating & writing
	Out Patient
6 Weeks	Active assisted flexion, abduction, internal and external rotation in supine and progress to sitting position as soon as the patient is able. Progress to active when possible Begin isometric strengthening of all muscle groups but concentrate on strengthening the deltoid
8 Weeks+	Encourage active movement into all ranges with some gentle self-stretching at the end of range. Progress isotonic strengthening though range Regularly stretch the joint to the end of its available range

Continue to strengthen the deltoid for 6-months.

Improvement continues for 18 months to 2 years and the patients should continue exercising until their maximum potential has been reached.

Driving	After 6 weeks
Golf	3 Months
Lifting	Light lifting can begin at 6 weeks. Avoid lifting heavy items for 6 months.
Return to work	Sedentary job: 6 weeks Manual job: Guided by Surgeon