Arthroscopic Posterior Stabilisation

Indications:

  • Performed for recurrent posterior dislocation

Protocol

 Post op

Day 1 - 3 weeks

Level 1 Exercises
  • External Rotation brace for 3 weeks (can remove for washing and exercise; wear on outside of clothes).
  • Teach axillary hygiene
  • Teach postural awareness and scapular setting
  • Active assisted ROM as comfortable (use 'safe zone' as guide)
  • Core stabiliity exercises with sling (as appropriate)
  • No combined forward flexion and Internal rotation exercises
  • Do not force or stretch

3 -6 Weeks

Level 2-3 Exercises
  • Wean off sling
  • Progress Active assisted to Active ROM as comfortable
  • Commence proprioceptive exercises (minimal weightbearing below 90 degrees)
  • No combined forward flexion and Internal rotation exercises
  • Do not force or stretch

6 - 12 Weeks

Progress to Level 3+ Exercises
  • The sling is removed by 6 weeks
  • Regain scapula & glenohumeral stability working for shoulder joint control rather than range
  • Gradually increase ROM
  • Strengthen - sports specific
  • Increase proprioception through open & closed chain exercise
  • Progress core stability exercises
  • Incorporate plyometrics and pertubation training
  • After 2 months any residual tightness to internal rotation may be addressed by specific stretching exercises

 

Milestones
Week 6  Active elevation to pre op level
Week 12

Minimum 80% range of external rotation compared to asymptomatic side

Normal movement patterns throughout range
Failure to achieve milestones     Referral to shoulder clinic

 

See Post-Operative Exercises

 Return to functional activities (guide to commence activity)
Return to work

Sedentary job: as tolerated

Manual job: 3 months
Driving 6-8 weeks
Swimming

Breaststroke: 6 weeks

Freestyle: 12 weeks

Golf

 3 Months
Lifting Light lifting can begin at 3 weeks. Avoid lifting heavy items for 3 months.
Contact Sport E.g. Horse riding, football, martial arts, racket sports and rock climbing: 3 months