Reverse Shoulder Replacement
Severe cuff arthropathy, shoulder arthritis (certain indications), revision surgery
- Polysling with body belt fitted in theatre
- Finger, wrist and elbow movements
- Cold compression
- Drain removal after 24 hours
- 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
- 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
- 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.
Return to functional activities
||After 6 weeks
||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