Total Shoulder Arthroplasty — (TSA) / Hemiarthroplasty

Massachusetts General Hospital · MGH Sports Medicine

Weight-Bearing

Sling in neutral rotation with abduction pillow (30-45 deg) wks 0-3; wean sling Phase II (wks 4-6); discontinue Phase III (wks 7-8)

Key Restrictions

No shoulder AROM Phase I; no reaching behind back (especially IR); no excessive ER or ABD Phase I-II (ER ≤30 deg Phase I, ER ≤30 deg scapular plane Phase II); no lifting >coffee cup through Phase III; no supporting body weight with hands; avoid shoulder hyperextension (pillow behind elbow in supine x 6-8 wks); rotator cuff repair concomitant: progress by criteria not time; secondary to fracture: same criterion-based approach

Timeline & Phases

6 phases: Phase I (0-3 wks, PROM), Phase II (4-6 wks, AAROM/AROM + periscapular/RTC), Phase III (7-8 wks, full ROM, discontinue sling), Phase IV (9-10 wks, light resistance), Phase V (11-14 wks, progressive strengthening), Phase VI (15+ wks, return to function)

Notes

Covers TSA and hemiarthroplasty; criterion-based progression; RTC external rotators activated Phase II; motor control (rhythmic stabilization) Phase II; sidelying horizontal ADD stretch Phase II; covers rotator cuff repair and fracture arthroplasty variants; complications to monitor: fever, numbness/tingling, excessive drainage, uncontrolled pain, acromion tenderness. [Archived copy — original Massachusetts General Hospital URL retired in the Mass General Brigham site migration; Wayback snapshot 2025-07-19.]

Surgeon / Author

MGH Sports Medicine