Rehabilitation Protocols
These protocols are provided as a reference for patients and their treating allied health team. They represent my default post-operative pathway, informed by current peer-reviewed evidence.
Individual patients may be given modified instructions based on intra-operative findings, tissue quality, fixation choice and other clinical factors. Where Dharsh’s written instructions differ from the protocol here, the instructions in the operation report/letter take precedence — please contact our rooms if in any doubt.
Shoulder
Reverse Total Shoulder Arthroplasty
Deltoid-focused rehabilitation after reverse geometry shoulder replacement.
Download PDFAnatomic Total Shoulder Arthroplasty
Subscapularis-protective protocol after standard shoulder replacement.
Download PDFProximal Humerus ORIF
Locking-plate fixation for displaced proximal humerus fractures.
Download PDFAcromioclavicular Joint Repair (Acute)
Coracoclavicular suture-button repair for acute high-grade AC dislocation.
Download PDFAcromioclavicular Joint Reconstruction (Chronic)
Graft reconstruction of the coracoclavicular ligament for chronic instability.
Download PDFLatarjet Procedure
Coracoid bone block procedure for recurrent anterior instability with bone loss.
Download PDFAnterior Arthroscopic Shoulder Stabilisation (Bankart)
Arthroscopic labral repair for anterior shoulder instability, with or without remplissage.
Download PDFPosterior Arthroscopic Shoulder Stabilisation
Arthroscopic posterior labral and capsular repair for posterior instability.
Download PDFArthroscopic Rotator Cuff Repair
Arthroscopic tendon-to-bone repair; tear-size-stratified pacing.
Download PDFSubacromial Decompression and Bursectomy
Arthroscopic decompression for refractory impingement. Rapid early rehabilitation.
Download PDFElbow
Distal Biceps Repair (Acute)
Acute reattachment with early controlled motion.
Download PDFDistal Biceps Reconstruction (Chronic)
Tendon-graft reconstruction for chronic distal biceps rupture. More protective pathway.
Download PDFElbow Hemiarthroplasty
Distal humerus replacement for unreconstructable intra-articular fractures.
Download PDFTotal Elbow Arthroplasty
Elbow joint replacement with lifelong lifting precautions.
Download PDFDistal Humerus / Complex Elbow ORIF
Dual-plate fixation for intra-articular distal humerus fractures.
Download PDFOlecranon ORIF
Tension-band or plate fixation for olecranon fractures.
Download PDFRadial Head ORIF
Screw or plate fixation for radial head fractures. Early motion emphasis.
Download PDFLateral Collateral Ligament Repair
Direct suture-anchor repair for acute posterolateral rotatory instability.
Download PDFLateral Collateral Ligament Reconstruction
Tendon-graft reconstruction for chronic posterolateral rotatory instability.
Download PDFMedial (Ulnar) Collateral Ligament Repair
Suture-tape–augmented UCL repair. Accelerated return to throwing.
Download PDFMedial (Ulnar) Collateral Ligament Reconstruction
Tendon-graft UCL reconstruction in chronic injuries.
Download PDFElbow Arthroscopic Debridement / Loose Body Removal
Arthroscopic clean-up for mechanical symptoms. Rapid return to activity.
Download PDFOther
Clavicle ORIF — Plate Fixation
Rigid plate fixation for displaced midshaft or lateral clavicle fractures.
Download PDFClavicle ORIF — Intramedullary Screw
Minimally-invasive intramedullary fixation. Union dependent progression.
Download PDFDistal Radius ORIF
Volar-plate fixation for distal radius fractures.
Download PDFForearm (Radius and/or Ulna) ORIF
Plate fixation of shaft fractures.
Download PDFScaphoid ORIF
Screw/plate fixation dependent on fracture pattern and need for grafting. Union dependent grip and load progression.
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