Arthoscopic Posterior Stabilisation

This information has been displayed with the kind permission of Lennard Funk and SportsInjuryClinic. Parts of the pages have been copied from Shoulderdoc.co.uk and SportsInjuryClinic.net.


Arthroscopic Posterior Stabilisation

Indications: Performed for recurrent posterior dislocation

 

Post Operative Protocol

Post op
Day 1 – 3 weeksLevel 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 WeeksLevel 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 WeeksProgress 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 internal rotation compared to asymptomatic side 
Normal movement patterns throughout range
Failure to achieve milestones Referral to shoulder clinic

 

Return to functional activities:

Return to work Sedentary job: as toleratedManual job: 3 months
Driving 6-8 weeks
Swimming Breaststroke: 6 weeksFreestyle: 12 weeks
Golf 3 Months
Lifting Light lifting can begin at 3 weeks. Avoid lifting heavy items for 3 months.
Contact Sport E.g. Rugby, horse riding, football, martial arts, racket sports and rock climbing: 3 months

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