Total Shoulder Arthroplasty — (TSA) / Hemiarthroplasty

Brigham and Women's Hospital · Reg B. Wilcox III PT; Dept. of Rehabilitation Services

Weight-Bearing

Sling continuously 3-4 wks; no shoulder AROM Phase I; no driving x 3 wks

Key Restrictions

No AROM Phase I; no motion behind back especially IR; no excessive ER or sudden movements; no supporting body weight; no soaking incision x 2 wks; pillow behind elbow in supine x 6-8 wks ('always visualize elbow while on back'); no heavy lifting >coffee cup through Phase II; if concomitant RC repair or fracture/cuff arthropathy: progress by criteria not time; forceful stretching not indicated if ROM criteria not met — use Grade I oscillations; PROM ≠ stretching (emphasized)

Timeline & Phases

3+ phases: Phase I Immediate Post-Surgical (wks 0-4, PROM progressive), Phase II (wks 4-8, AAROM/AROM, initiate RC), Phase III (wks 8-12+, progressive strengthening, return to function); treatment algorithm decision tree included

Notes

2016; 'PROM is not stretching!!!!!!!!' explicitly noted; SPADI at first ambulatory visit, every 30 days and discharge; Phase I criteria: ≥90 deg PROM FF, ≥45 deg ER scapular plane, ≥70 deg IR scapular plane at 30 deg ABD; references Wilcox et al 2005 JOSPT as foundational protocol; treatment algorithm (decision tree) for progressing the rehab program. [Archived copy — original Brigham and Women's Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2024-06-05.]

Surgeon / Author

Reg B. Wilcox III PT; Dept. of Rehabilitation Services

Published

2016