How Long Do You Wear a Sling After Shoulder Replacement?

How long do you wear a sling after shoulder surgery? For me, for an anatomic shoulder replacement, it's 4 weeks. That's based on the study we did where we found that those people who were in a sling 4 weeks had higher healing than those who did not remain in the sling and started doing early range of motion. And that's because with an anatomic shoulder replacement, you're relying on the rotator cuff. And when you go into the shoulder, you typically take down the subscapularis, which is a rotator cuff muscle in the front of the shoulder. I take that off with a fleck of bone called an osteotomy to get inside of the shoulder. That allows you see very clearly, but you need to repair that back down and have that heal. So by being asleep for 4 weeks, you protect that healing from occurring. Now, there are people who are also looking at subscapularis-sparing approaches. I think that's a future thing, but right now I don't feel that's mainstream because the techniques that are being really used are inadequate, in my view, to sufficiently restore the anatomy in the vast majority of cases. So while it's appealing, It's not yet a mainstream procedure. I think that will change in the future with more technology coming on board. With a reverse shoulder replacement, for me, I put people in a sling for 2 weeks. Now, with a reverse shoulder replacement, because stability is provided by the joint itself, less needed or less dependent upon the subscapularis for healing. So we can do some early range of motion right out of the gate, doing table slides in front of you and passive external rotation out to the side. That allows you to get some early motion going and prevent disuse osteopenia that may be associated with that stress fracture phenomenon I talked about earlier. So what we're seeing actually with this approach is people that reverse shoulder replacement are getting their function back very quickly, even raising their arm overhead within a few weeks.