Reverse Total Shoulder Replacement

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

This has caused pain and loss of active movement in the arm.

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

Mastersling with body belt fitted in theatre
Cryo-cuff administered to reduce inflammation
Finger, wrist and radio-ulnar mobilising exercises
Active elbow flexion and extension started
Shoulder Girdle exercises and postural awareness

Day 2 – 5 (Discharge)

Body belt removed – stay in sling
Axillary hygiene taught
Continue Cryo-cuff
Maintain exercises as above
Start GENTLE pendular swinging in forward leaning

Week 1 – 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
Start Scapular setting exercises
Continue pendular exercises as above
Continue shoulder, elbow, wrist and hand exercises
Stay in sling except when exercising

Week 3 – 6 - Clinic Review

Start formal physiotherapy – to increase range of motion.
Avoid forcing any movement. Do not push the shoulder into painful positions. Start the Deltoid Regime – see A4 booklet given to you in hospital,
under the instruction of your physiotherapist
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 as described in the hospital booklet
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 as described in the hospital booklet
Use the arm and hand as fully and normally as possible, in comfortable positions.