Total Shoulder replacement

Question 1

Aims

Answer 1

> Reduce pain + restore RoM

> usually for severe fracture or late stage OA

Question 2

Traditional procedure

Answer 2

> Anterior access between pecs and deltoid
Subscapularis is cut
Arthritic areas are removed
Implants = inserted (new glenoid and spheroid humeral head)
repair + close

Question 3

Reverse

Answer 3

> Glenoid ball is inserted
humeral cup is inserted
used if rotator cuff is badly torn or traditional replacement has failed (uses deltoid to do rotator cuff job)

Question 4

Post-op physio

Answer 4

> Early stages
- sling with early RoM exercises
- ADL education
- pain management
> Mid 
- Out of sling gradually
- RoM focus - scapula rhythm 
- Isometric rotator cuff strength 
> Late 
- strength + function focus
- goal dependent