Rehabilitation following reverse total shoulder arthroplasty. Pdf rehabilitation following total shoulder arthroplasty. However, there is no consensus concerning the rehabilitation protocol following surgery. The shoulder is a ball and socket joint that enables you to raise, twist, bend and move your arms forward, to the sides and behind you. Rehabilitation protocol for total shoulder arthroplasty and hemiarthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Backgroundthe goals of this study were to determine the incidence in the united states of preoperative threedimensional imaging prior to anatomic total shoulder arthroplasty for osteoarthritis and. Rehabilitation after shoulder arthroplasty uw orthopaedics. Uva sports medicine university of virginia school of. The shoulder arthroplasty procedure is performed to improve function, increase active range of motion and reduce pain of the shoulder. The following steps can help you have optimal recovery.
Department of rehabilitation services reverse total. Rehabilitation protocol for total shoulder arthroplasty and. This protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Shoulder arthroplasty an overview sciencedirect topics. Total shoulder arthroplastyhemiarthroplasty protocol. Prom arom as tolerated, except no active extension for 6 the tendon is taken down for the surgery and then repaired afterwards. Regain strength and obtain functional range of motion rom. Total shoulder replacement rehabilitation guidelines. Trends and impact of threedimensional preoperative imaging. This procedure replaces your damaged hip joint with an artificial hip implant.
The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol. The reverse or inverse total shoulder arthroplasty rtsa, first described by grammont et al. Anatomic total shoulder arthroplasty rehabilitation. The goal of the following exercises is to regain range of motion while limiting pain and inflammation. Other treatment options including medications, injections, physical therapy, or other types of surgery will also be discussed and considered. Reverse total shoulder arthroplasty rehab protocol 1 rehabilitation guidelines for standard reverse total shoulder arthroplasty rtsa note. Shoulder replacement surgery was first performed in the united states in the 1950s to treat severe shoulder fractures. Victoria bc v8z 0b9 tel 250 940 4444 fax 250 385 9600 page 1 june 2017 v1s. Gallandkirby total shoulder arthroplasty postsurgical rehabilitation protocol postop days 1 14 sling for comfort, dc after 45 days sleep with pillow under shoulder arm for comfort hand squeezing exercises elbow and wrist active motion arom pendulum exercises. Shoulder hemiarthroplasty physical therapy protocol. This is the information which might be shared with patients after a shoulder arthroplasty. Reverse total shoulder arthroplasty robert rolf md and tim elser pt, dhsc, atc, ocs indications reverse total shoulder replacement is indicated for use in grossly rotator cuff deficient joints with severe arthropathy, or for use when a previous joint replacement has failed with a. Contact ohio state sports medicine at 6142932385 if questions arise.
Department of rehabilitation services reverse total shoulder arthroplasty protocol. Total shoulder replacement protocol sports and ortho. Journal of orthopaedic and sports physical therapy. Rehabilitation following total shoulder arthroplasty reg b. Shoulder arthroplasty protocol shoulder arthroplasty protocol this rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure. Reverse total shoulder replacement postoperative rehabilitation this protocol was developed for patients who have undergone a reverse total shoulder replacement. After total shoulder replacement or hemiarthroplasty which involved a rotator cuff repair, or was done for a fracture.
Shoulder rehabilitation treatment includes activity modification, stretching, and strengthening the affected limb. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone. Reverse total shoulder arthroplasty rtsa rehabilitation protocol. It takes about 46 weeks for it to grow back into the and regenerate a blood and prom in biceps flexion 6 weeks rom goals. Total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint. This protocol will vary in length and aggressiveness depending on factors such as. Considerations for the reverse shoulder arthroplasty rehabilitation program many different factors influence the postoperative reverse shoulder arthroplasty rehabilitation outcome, including surgical approach, concomitant repair of the rotator cuff, arthroplasty secondary to fracture.
It is by no means intended to be a substitute for a physical. Rehabilitation guidelines for standard reverse total. Treatment algorithm for progressing the rehabilitation program for a patient that has had a total shoulder arthroplasty. Shoulder replacement rehabilitation program johns hopkins.
Patients who present with a history of rheumatoid arthritis, osteoarthritis, avascular necrosis, sickle cell infarction, irradiation necrosis, ochronosis, or gout may benefit from this procedure 2 fig. Physical therapy rehabilitation protocols shoulder rehabilitation protocols. Total shoulder arthroplasty rehabilitation guideline sanford health. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. Pdf total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint. Prom fe and elevation in scapular plane in supine to 90, er to 10, no ir rom 3. Total shoulder arthroplasty rehabilitation guideline. Periscapular submax pain free isometrics in scapular plane 5. Patients, who have continued shoulder pain and loss of function in the.
Active rom exercises should be performed with the elbow close to the body to avoid excessive stretch of the reconstructed elbow collateral ligaments. Revision surgery or cases involving bonegrafting procedures may undergo modifications to the below guideline. Shoulder replacement surgery is less common than hip or knee. Postoperative rehabilitation protocol total shoulder or reverse shoulder arthroplasty phase i. Over the years, shoulder joint replacement has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis. Strengthening the muscles that support your shoulder will help keep your shoulder joint stable. Paff the intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone undergoing total shoulder arthroplasty or hemiarthroplasty. Presence of a functional rotator cuff intact or repaired type of shoulder replacement anatomic or reverse presence of a. It involves reversing the normal anatomy of the shoulder by placing the ball on the socket, and the socket is placed in the position of the humeral head. This is because the articular surface of the round. If you are willing to commit to such a rehabilitative effort you will achieve maximum benefit from your shoulder arthroplasty. American shoulder and elbow surgeons standardized shoulder.
Reverse total shoulder arthroplasty protocol 1 boston shoulder. Before it can be applied to a specific clinical situation however it needs to be tailored to the patient the surgery and the surgeon. Rehabilitation guidelines for shoulder arthroplasty and. Reverse total shoulder arthroplasty protocol 1 brigham and. In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone humerus by.
Shoulder arthroplasty protocol northeast orthopedics and. In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone humerus by a stem that fits within it. Rehabilitation guidelines for standard reverse total shoulder. The anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. Reverse total shoulder arthroplasty rehab guidelines. Keeping these muscles strong can relieve shoulder pain and prevent further injury.
Phase i immediate post surgical phase meets criteria for progression to phase ii. Total shoulder arthroplasty rehabilitation guideline this rehabilitation program is designed to return the individual to their activities as quickly and safely as possible. Sep 06, 2016 the goals of our phase 2 program for shoulder replacement rehabilitation are to progress to full range of motion of the shoulder and to start light strengthening exercises. Less common, but just as successful in relieving joint pain is a shoulder replacement.
There is a higher risk of shoulder dislocation following a reverse total shoulder arthroplasty rtsa than with conventional shoulder replacement. Aromaarom cervical spine, elbow, wrist, and hand 4. Reverse total shoulder arthroplasty the reverse, or inverse, total shoulder arthroplasty rtsa. Rehabilitation protocol for total shoulder arthroplasty. Mathes about shoulder replacement surgery shoulder replacement surgery is a major operation. Reverseinverse total shoulder arthroplasty case type diagnosis. Modifications to this guideline may be necessary dependent on physician. Total shoulder arthroplasty rehabilitation protocol your shoulder rehabilitation program begins while you are in the hospital. Use of a sling for 3 weeks postop unless otherwise indicated.
Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. Reverse total shoulder arthroplasty rtsa background. Specific interventions should be based on the needs of the individual and. Rehabilitation guidelines for shoulder arthroplasty and reverse ball and socket arthroplasty the anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. Total shoulder arthroplasty protocol boston shoulder institute. In this procedure, the humeral head and glenoid surface are replaced with prosthetic components. Reverse total shoulder replacement is performed for a variety of indications. The shoulder requires two years of rehabilitative exercises to reach maximal function after a shoulder replacement. Each case can be very different depending on the goals of the patient, the age of the. Subscapularis insufficiency and the risk of shoulder dislocation after reverse shoulder arthroplasty. This is because the articular surface of the round humeral head is approximately four times greater than. This rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure.
Rehabilitation protocol for reverse shoulder arthroplasty. Total elbow arthroplasty rehabilitation protocol introduction goal. The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. Your doctor will probably try to treat you with drugs or physical therapy first. Stability and mobility of the shoulder joint is now dependent upon the deltoid and periscapular musculature. This protocol is intended to guide clinicians and patients through the post operative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Immediate motion weeks 0 to 8 goals allow early healing of capsule increase passive range of motion decrease shoulder pain retard muscular atrophy and prevent rotator cuff inhibition brace discontinue use after six to eight weeks unless otherwise advised by dr. Total shoulder replacement postop physical therapy protocol. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Shoulder arthroplasty is well established for patients with. Total shoulder arthroplasty post op rehabilitation patient name. The postoperative course emphasizes early range of motion and gradual progression of strength and restoration of function. Shoulder hemiarthroplasty physical therapy protocol phase i. Rehabilitation protocol for total hip arthroplasty.
Variances will be communicated by the surgeon directly to rehabilitation services. Rehabilitation following reverse shoulder arthroplasty. The intent of this protocol is to provide the physical therapist with a guideline for the postoperative rehabilitation management for a patient who has undergone a reverse total shoulder arthroplasty rtsa. For the first 6 weeks of the recovery phase, the focus of rehabilitation is on maintaining the motion that was recovered at surgery. Phase i immediate post surgical phase meets criteria for progression to.
The most common indications are rotator cuff tear arthropathy. This protocol was adapted from the articles titled. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total shoulder arthroplasty rtsa. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. Always be sure to ice your shoulder after you complete your exercises. The primary goals of early rehabilitation are to promote soft tissue healing and preserve glenohumeral mobility. No combined shoulder addextir behind back no glenohumeral gh joint extension beyond neutral. Total shoulder arthroplasty tsa is indicated for patients with glenohumeral arthritis. Total shoulder replacement arthroplasty for shoulder arthritis total shoulder replacement arthroplasty is a wellestablished surgery for restoring comfort and function to the arthritic shoulder. This glenoid loading leads to excessive shearing forces with resultant glenoid component loosening. It is designed for rehabilitation following total shoulder arthroplasty. The following is a guideline for progression of postoperative treatment. Shoulder dislocation precautions precautions should be implemented for the first 12 wks postoperatively unless surgeon specifically advises patient or therapist differently.
Sling immobilization for 6 weeks except for bathing and therapeutic exercises. The rotator cuff is either absent or minimally involved with the rtsa. Total shoulder arthroplasty rehabilitation protocol. Rehabilitation guidelines for shoulder arthroplasty and reverse. If you have any questions about this program please be sure to ask your doctor. Reverse total shoulder replacement rehabilitation guidelines.
Reverse total shoulder arthroplasty rtsa is indicated for patients with glenohumeral arthritis and a poorly functioning rotator cuff. Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. Initiate gentle strengthening exercises with the primary goal of activating the quadriceps. Shoulder arthroplasty is used to provide a painless range of motion rom by replacing or resurfacing the articulating surface of the humeral head and the glenoid. Rehabilitation following total shoulder arthroplasty.
Shoulder replacement rehabilitation phase 2 shoulder. Early goals are to reduce shoulder stiffness and pain. Total shoulder arthroplasty clinical practice guideline progression is time and criterionbased, dependent on soft tissue healing, patient demographics and clinician evaluation. Make sure to rest from all painful activities until swelling subsides. Department of rehabilitation services reverse total shoulder. The goals of our phase 2 program for shoulder replacement rehabilitation are to progress to full range of motion of the shoulder and to start light strengthening exercises. The rtsa is a specific type of shoulder replacement.
231 824 1401 1623 1542 420 1307 1011 1550 654 621 1116 1541 1336 80 921 1023 800 26 39 784 172 551 196 934 362 1389 685 1247 1033 701 926 1192 160