Reverse Shoulder Replacement (Delta 3)

Indications:

Severe Cuff arthropathy
Salvage procedure for failed Hemiarthroplasties in elderly

	In Patient
Day 1	Mastersling with body belt fitted in theatre Finger, wrist and elbow movements
Week 1 Level 1 Exercises	Body belt removed 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
	Out Patient
6 Weeks Level 2 Exercises	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
8 Weeks+ Progress to level 3 exercises	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 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

Driving	After 6 weeks
Swimming	Breaststroke: 6 weeks Freestyle: 12 weeks
Golf	3 months
Lifting	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