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Stiff Shoulder Pathway

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4. Daycase procedure, discharge and follow-up

Planning for a daycase procedure (MUA with glenohumeral steroid injection or ACR with MUA), discharge and follow-up.

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Yes

Admission on the day of the procedure

Admission to orthopaedic elective ward
Appropriate list utilisation and allocation to ensure adequate time for recovery and discharge
Venous Thromboembolism (VTE) risk assessment
Reaffirmation of consent process
Theatre list to have specialist anaesthetist to ensure adequate analgesia
Standard intra-operative analgesic regime
Use of sutures and routine dressings as per local unit practice
Use of sling as per local unit practice and UK FROST Trial rehabilitation guidelines
Monitoring of vital signs in recovery

Discharge planning

Nurse-led discharge criteria

Reasonably pain free
Analgesia
Wound check
Voiding urine
Therapy goals achieved, ambulant
Care packages in place as needed
Contact numbers if concerns on discharge

Physiotherapist

Provided Patient Booklet containing advice, education and exercises
Organise outpatient physiotherapy appointment to begin within 24 hours*
Sling as per local guidelines – no need for a period of immobilisation

*Timeframes are indicative of minimum standards

Follow-up

Post-discharge

Rehabilitation as an outpatient following UK FROST Trial Guidance
Orthopaedic review 6 weeks* post-operative
12-months or at discharge patient-reported outcome measures (PROMs)

*Timeframes are indicative of minimum standards

Stiff Shoulder Pathway

1. Presentation and referral
2. Physiotherapy
3. Orthopaedic referral
4. Daycase procedure, discharge and follow-up

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