Important rehabilitation management concepts to consider for a postoperative. Reverse total shoulder replacement postoperative rehabilitation this protocol was developed for patients who have undergone a reverse total shoulder replacement. Reverse shoulder arthroplasty rsa shows a growing number of implantations and is a valuable option to improve shoulder function and decrease pain. Reverse total shoulder replacement rehab sports doctor. It is not intended to be a substitute for special instructions from. In a reverse total shoulder replacement, the socket and metal ball are switched. Contact ohio state sports medicine at 6142932385 if questions arise. The intent of posting these standards of care and protocols is to provide clinicians and patients. Department of rehabilitation services reverse shoulder arthroplasty protocol. Reverse total shoulder arthroplasty rtsa is indicated for patients with glenohumeral arthritis and a.
Phase i immediate post surgical phase meets criteria for progression to. This procedure is specifically designed for the treatment of glenohumeral gh joint arthritis or complex fractures, when associated with irreparable rotator cuff rc damage or in the presence of rc arthropathy. Reverse total shoulder replacement therapy protocol general information. Reverse shoulder arthroplasty patient personalized rehabilitation. Reverse shoulder arthroplasty physical therapy protocols. T physical therapy, protocols, shoulder rehabilitation he first total shoulder arthroplasty tsa was performed by jules emile pean in 1893 for the purpose of treating tuberculous arthritis of the shoulder. 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. 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. However, there is no consensus concerning the rehabilitation protocol following surgery. Rehabilitation following reverse shoulder arthroplasty. Jennifer penrose important rehab guidelines to consider avoid shoulder ext past neutral for 12 weeks. Rehabilitation guidelines for shoulder arthroplasty and reverse. Maintain surgical motion early, but protect subscapularis repair by avoiding.
Learn about physical therapy standards of care and protocols from the rehabilitation services at brigham and womens hospital. Total shoulder replacement postop physical therapy protocol. In this procedure, the humeral head and glenoid surface are replaced with prosthetic components. A better understand ing of rc deficiency, the rtsa prosthesis. The reverse shoulder replacement has the ball of the shoulder joint where the socket should be and the socket where the ball usually is in normal anatomy. Reverse total shoulder exercises 46 wks post operative.
The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. The intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone under going total shoulder arthroplasty or. Reverse total shoulder replacement is a complex procedure and is warranted by certain conditions. The major difference between a standard shoulder replacement and a reverse procedure is that in a reverse shoulder replacement the ball and socket parts of the shoulder joint switch sides. Reverse total shoulder replacement is indicated for use in grossly rotator cuff deficient joints. Rehabilitation after reverse shoulder arthroplasty page 1 rehabilitation after reverse shoulder arthroplasty. Reverse total shoulder arthroplasty clinical practice guidelines progression is time and criterionbased, dependent on soft tissue healing, patient demographics and clinician evaluation. Shoulder arthroplasty protocol shoulder arthroplasty protocol this rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. Reverse total shoulder replacement therapy protocol. 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. May 27, 2015 reverse shoulder replacement surgery and rehabilitation. Minimize heavy, excessive cyclic loads for the first 6 months.
Rehabilitation following reverse shoulder arthroplasty springerlink. Hospital to 1st follow up protect subscapularis 0 to 2 weeks patients may shower immediately over clear plastic, waterproof dressing. Use of a sling for 3 weeks postop unless otherwise indicated. Rehabilitation protocol for reverse shoulder arthroplasty. Presence of a functional rotator cuff intact or repaired type of shoulder replacement anatomic or reverse presence of a. This protocol will vary in length and aggressiveness depending on factors such as. Biomechanical summary of reverse shoulder arthroplasty. These patients often have severe limitations in shoulder function secondary to a massive rotator cuff tear. This is because the articular surface of the round. Maintenance of good postural positioning when performing all exercises.
Exercises for patient with reverse total shoulder arthroplasty 46 weeks postoperative protocol driven. There will always be individual differences amongst patients regarding progression and tolerance of specific activities. Rehabilitation protocol for total shoulder arthroplasty. Reverse total shoulder arthroplasty rtsa is designed specifically for the treatment of glenohumeral shoulder arthritis when it is associated with irreparable rotator cuff damage, complex fractures as well as for a revision of a previously failed conventional total shoulder arthroplasty. Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the ohio state sports medicine physical therapy team and sometimes, other healthcare providers. Each case can be very different depending on the goals of the patient, the age of the. Postoperative protocols rotator cuff tear arthropathy reverse prosthesis general information reverse shoulder replacement for cuff tear arthropathy is an operation for pain relief. General time frames are given for reference to the average. Rehabilitation following total shoulder arthroplasty. Rehabilitation guidelines after surgery, sports medicine. Reverse total shoulder replacement postop protocol. Reverse total shoulder arthroplasty rtsa is indicated for patients with. Total shoulder arthroplastyhemiarthroplasty protocol.
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. Total shoulder replacement postoperative physical therapy. Revision surgery or cases involving bonegrafting procedures may undergo modifications to the below guideline. Rehabilitation following total shoulder arthroplasty reg b. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. Rehabilitation protocols ohio state sports medicine. Specific interventions should be based on the needs of the individual and. Avoid internal rotation, adduction and extension as patients have a high likely hood of. Reverse or inverse total shoulder arthroplasty rtsa is designed specifically. Reverse total shoulder arthroplasty rehab protocol 1 rehabilitation guidelines for standard reverse total shoulder arthroplasty rtsa note. Physician incision approach is important in rtsa rehab. Boudreau s1, boudreau ed, higgins ld, wilcox rb 3rd.
Reestablish dynamic shoulder stability precautions while lying supine, a small pillow or towel roll should be place behind the elbow to avoid shoulder hyperextension, anterior capsule stretch, or subscapularis stretch. Shoulderelbow surgery inverness department of orthopedics 303 694 3333 university of colorado anschutz medical campus 720 8481900 rehabilitation protocol shoulder arthroplasty phase 1. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. Department of rehabilitation services reverse total. 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. Brigham and womens hospital reverse total shoulder arthroplasty protocol, brian cole reverse shoulder replacement rehab protocol pt name and date. The shoulder arthroplasty procedure is performed to improve function, increase active range of motion and reduce pain of the shoulder. Reverse shoulder replacement uw orthopaedics and sports. Reverse total shoulder replacement is performed for a variety of indications. The intent of this protocol is to provide the physical or occupational therapist with a guideline and treatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total shoulder replacement rtsr. This procedure is specifically designed for the treatment of glenohumeral gh joint.
Sling is to be worn full time outside of the home and sleeping for 23 weeks, prn in the home may. A conventional shoulder replacement device mimics the normal anatomy of the shoulder. Reverse total shoulder replacement rtsr is designed specifically for the treatment of glenohumeral gh arthritis when it is associated with irreparable rotator cuff rc damage, complex fractures as well as for a revision of a previously failed conventional total shoulder. Since there are no actual guidelines regarding a rehabilitation protocol after rsa, the following paragraph summarizes the published protocols in. 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. This protocol provides you with general guidelines for the rehabilitation of the patient with a reverse total shoulder replacement. The rehabilitation program will gradually progress to more strengthening and control type exercises. Individuals are most likely to benefit from reverse shoulder replacement surger if they are well motivated and in good health. It is by no means intended to be a substitute for a physical. This is because the articular surface of the round humeral head is approximately four times greater than. Shoulders with active elevation of 90 degrees or more indicating good deltoid tension and stability may be treated with shoulder arthroplasty using a cuff tear arthropathy cta prosthesis. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Total shoulder arthroplasty tsa is indicated for patients with glenohumeral arthritis. Begin flexion, ir, er, and elevation in scapular plane, submaximal painfree shoulder isometrics in neutral, progress scapular and distal extremity strengthening.
Rehabilitation guidelines royal national orthopaedic. Therapeutic exercise o grip strengthening o elbowwristhand exercises o teach home exercises pendulums. Sling only to be worn while sleeping, no lifting of objects heavier than a coffee cup, no sudden movements, pillow to be placed under elbow when in supine. Reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. 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. Department of rehabilitation services reverse total shoulder. Physical therapy standards of care brigham and womens. Rehabilitation guidelines for standard reverse total. No shoulder rom no ip pt dislocation precautions patients following a rtsa do not dislocate with the arm in abduction and external rotation. Chams guidelines for physical therapy protocols following your reverse shoulder arthroplasty for the fastest and smoothest recovery.
Shoulder arthroplasty protocol northeast orthopedics and. Reverse or inverse total shoulder arthroplasty rtsa is becoming a widely accepted surgical intervention. Rehab protocols arthroscopic superior capsular repair. 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 shoulder arthroplasty rsa. Rehabilitation guidelines for shoulder arthroplasty and. The performance of the procedure is complete, but for the most optimal outcome, it is vital that you follow your post operative rehabilitation protocol. Patient was just approved to have sling removed and is. Reverse total shoulder replacement postop protocol penrose. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Reverse total shoulder replacement rehabilitation guidelines. Reverse total shoulder arthroplasty protocol 1 boston shoulder. Reverse shoulder arthroplasty physical therapy philosophy this protocol is to be utilized as a guideline. Reverse total shoulder arthroplasty rehab guidelines. Reverse total shoulder arthroplasty rtsa rehabilitation protocol.
Reverse total shoulder replacement rehabilitation guidelines for therapists anterior shoulder stabilisation rehabilitation guidelines for therapists posterior shoulder stabilisation rehabilitation guidelines for therapists inferior shoulder stabilisation rehabilitation guidelines for therapists. Reverse total shoulder arthroplasty rehabilitation protocol. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. There is a higher risk of shoulder dislocation following a reverse total shoulder arthroplasty rtsa than with conventional shoulder replacement. The most common indications are rotator cuff tear arthropathy.
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. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. Shoulder replacement rehab phase 1 shoulder replacement. Reverse shoulder replacement surgery and rehabilitation. Reverse total shoulder replacement sports and ortho. Sep 06, 2016 the goals of our phase i program for shoulder replacement rehabilitation are to protect the shoulder as it heals and to start gentle motion and muscle contraction exercises. Department of rehabilitation services reverse shoulder. Rehabilitation following reverse total shoulder arthroplasty jospt. Postoperative rehabilitation protocols shoulder shoulder arthroscopy general slap or anterior labral repair posterior labral repair rotator cuff repair cc ligament reconstruction latarjet procedure pec tendon repair pec tendon transfer total shoulder or reverse shoulder arthroplasty knee knee arthroscopy general knee microfracture or oats meniscus repair meniscus root repair mpfl. Progression through the protocol will depend on successful. Stability and mobility of the shoulder joint is now dependent upon the. Reverse total shoulder replacement johns hopkins shoulder.
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