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Anatomic total shoulder replacement​

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You have just undergone an anatomic total shoulder replacement with Kemble Wang. This is a type of shoulder replacement that is done for very arthritic shoulders that has mostly intact tendons

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This is a fairly major orthopaedic operation. The main bone and joint surface of the shoulder will have been replacement with an artificial one. It will take a while for you to heal from this operation, particularly with regard to the tendon repair at the front of the shoulder - the subscapularis - which must be protected until it heals. 

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The following is an xray of a patient who had a reverse shoulder replacement with Mr Wang. 

Anatomic total shoulder replacement

Postoperatively your arm will be in a sling. You can start coming out of the sling under supervision of  the physiotherapist and for prescribed exercises. However, you should remain in the sling most of the time during the first 4 weeks. 

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Wound and dressing: Your wound will have been closed with absorbable sutures. There will also be dermabond (skin glue) giving additional support. The wound would be covered with a waterproof dressing. You can shower with this wound dressing but do not let it overly soak. 

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It is normal to have some tingling or numbness or weakness following your procedure. This is often due to a nerve block performed preoperatively to help with your pain, or due to local anaesthetic injected into the wound. This will wear off in the first day or two.

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General Information / Goals:

 

  • You need time to allow for healing. After 6 weeks postop the recovery is usually 40%, after 12 weeks the recovery is 80%. The last 20% could take 6-12 months

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The following is your physiotherapy prescription:

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Weeks 0-4: 

 

  • Heat or ice before and after therapy sessions

  • home exercises 3 times daily.

  • Weeks 0-2: pendulars, elbow/wrist/hand ROM, 

  • Weeks 2-4: passive and active assisted elevation to 90, ER to 0 deg, scapular strengthening, aquatic therapy ok. 

  • No resisted internal rotation

 

Weeks 4-6

 

  • Active and active-assisted elevation to 90, ER to 45.

  • Start weaning out of sling at week 4 over a few days

  • No resisted internal rotation

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Weeks 6-10

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  • Start full active ROM and gentle strengthening 

  • Can start resisted internal rotation

  • No backward extension or scapular retraction in this phase

  • Concentric motions only

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Weeks 10

 

  • Full strengthening, no restrictions

  • Can start eccentric, plyometric exercises

  • Modality as per physiotherapist discretion

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