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Reverse Total Shoulder Replacement

The reverse total shoulder replacement is designed for shoulders that have severe arthritis with a deficient rotator cuff or following complex fractures with a deficient rotator cuff.

The design changes the mechanics of the shoulder allowing pain relief and an improvement in function and stability, particularly when using the arm in front and above shoulder level.

The operation is carried out under general anaesthetic and a nerve block, with the incision being approximately three inches long on the front-side of the shoulder. The arm is then placed in a sling with body belt.
 
Post Op: Day 1

  • Polysling fitted in theatre
  • Finger, wrist and elbow exercises
  • Shoulder Girdle exercises and postural awareness
  • Neck ROM exercises

 Day 2 (Discharge)

  • Axillary hygiene taught
  • Maintain exercises as above
  • Start GENTLE pendular swinging in forward leaning

 Discharge – Week 3

  • Start PASSIVE shoulder exercises – Flexion/extension, Int/external rotation
  • (Do NOT force any movement) as instructed by your physiotherapist
  • Use analgesia as required, regularly, to allow maximum comfort during all
  • arm exercises and daily functions

 Week 3 – 6

  • Start formal physiotherapy – to increase range of motion. Start with active assisted ROM exercises
  • Advice on analgesia
  • Continue pendular exercises
  • Avoid forcing any movement. Do not push the shoulder into painful positions.
  • Start Deltoid strengthening
  • Wean from sling as comfortable but always wear sling when outdoors.
  • Continue to stretch regularly throughout the day, where possible in lying,
  • maintaining good range of movement in the elbow, wrist and hand.
  • Slowly increase the daily use of the arm, but avoid painful activities

 Week 6 – 12

  • Continue with physiotherapy, as instructed
  • Increase the Deltoid regime
  • Stop wearing the sling
  • Continue stretches maximising range of motion in all directions
  • Use the arm and hand as fully and normally as possible, in comfortable positions

 Week 12 – Clinic Review

  • Continue stretches maximising range of motion in all directions
  • Continue with physiotherapy, as instructed
  • Increase the Deltoid regime
  • Use the arm and hand as fully and normally as possible, in comfortable positions.