Reverse total shoulder arthroplasty protocol 1 brigham and. Achilles tendon repair and rehab pdf anterior cruciate ligament more about uw health. Contact ohio state sports medicine at 6142932385 if questions arise. This is because the articular surface of the round humeral head is approximately four times greater than. Rehabilitation following total shoulder arthroplasty. Rehabilitation protocol for total shoulder arthroplasty and. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative. Shoulder arthroplasty and reverse ball and socket arthroplasty. 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. This protocol has been adapted from wilcox, arslanian, and millets protocol described in rehabilitation following total shoulder replacement, which was published in the journal of orthopedic and sports physical therapy, december 2005. The most common indications are rotator cuff tear arthropathy.
The intent of this protocol is to provide the therapist with a guideline for the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty. You have undergone a reverse total shoulder replacement procedure. Total shoulder arthroplastyhemiarthroplasty protocol cleveland. This procedure replaces your damaged hip joint with an artificial hip implant. Rehabilitation guidelines after surgery, sports medicine uw. Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. It is by no means intended to be a substitute for a physical. The actual post surgical physical therapy management must be based on the surgical approach, physical examfindings, individual progress, andor the presence. 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.
Remember, total shoulder arthroplasty protocol exists to ensure you experience a full, healthy recovery, so following guidelines is crucial and should not be. Reverse total shoulder arthroplasty rehab protocol 1 rehabilitation guidelines for standard reverse total shoulder arthroplasty rtsa note. Hip implants consist of 1 a smooth ball on a stem that fits into your thigh bone the femoral stem, and 2 a metal socket with a smooth liner that is attached to. 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. Total shoulder arthroplasty rehab protocol physical therapy haven. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder. Total shoulder arthroplasty hemiarthroplasty protocol. Rehabilitation following total shoulder arthroplasty reg b. The shoulder arthroplasty procedure is performed to improve function, increase active range of motion and reduce pain of the shoulder. Total shoulder arthroplastyhemiarthroplasty brigham and womens hospital. The intent of this protocol is to provide the physical therapist with a guideline treatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total shoulder arthroplasty rtsa. Rehabilitation guidelines after surgery, sports medicine. Standardized, consensus and evidence derived postoperative shoulder rehabilitation guidelines for patients following arthroscopic bankart, arthroscopicminiopen rotator cuff repairs and total shoulder arthroplasty have been developed by a multidisciplinary team of physical therapists, orthopedic surgeons and physicians known as surge.
The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Supine exercises should be done with a small rolled towel placed behind the elbow to avoid shoulder hyperextension and anterior capsular stretch. Reverse shoulder arthroplasty rsa shows a growing number of implantations and is a valuable option to improve shoulder function and decrease pain. 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. 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. After total shoulder replacement or hemiarthroplasty for most.
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. Reverse total shoulder arthroplasty clinical practice guidelines progression is time and criterionbased, dependent on soft tissue healing, patient demographics and clinician evaluation. 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. Reverse or inverse total shoulder arthroplasty rtsa is designed. The performance of the procedure is complete, but for the most optimal outcome, it is vital that you follow your post operative rehabilitation protocol. Rehabilitation protocols ohio state sports medicine. 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.
Shoulder replacement rehabilitation program johns hopkins. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a. Reverse total shoulder arthroplasty rtsa is indicated for patients with glenohumeral arthritis and a poorly functioning rotator cuff. Reverse total shoulder arthroplasty rtsa is designed specifically for the treatment of glenohumeral shoulder arthritis when it is associated with. Rehabilitation guidelines for standard reverse total. Total shoulder arthroplasty protocol boston shoulder institute. Rehabilitation following reverse shoulder arthroplasty. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. May 11, 2012 physical therapist jennifer petrakis demonstrates stages of rehabilitation you are likely to experience following a total shoulder replacement. No shoulder rom no ip pt dislocation precautions patients following a rtsa do not dislocate with the arm in abduction and external rotation.
The performance of the procedure is complete, but for. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Standardized, consensus and evidence derived postoperative shoulder rehabilitation guidelines for patients following arthroscopic bankart, arthroscopicminiopen rotator cuff repairs and total. 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. The following is an outlined progression for rehab. There is a higher risk of shoulder dislocation following a reverse total. 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.
Total shoulder arthroplasty total shoulder arthroplasty, or tsa, is a procedure used to replace the diseased or damaged ball and socket joint of the shoulder with a prosthesis made of polyethylene and metal components. Rehabilitation for total shoulder replacement part i. Patients with rtsa dont dislocate with the arm in abduction and external. Rehabilitation guidelines for reverse total shoulder arthroplasty 4 p a g e phase iv continued cardiovascular exercises arm bike, stationary bike, walking, light jogging progression. Physician incision approach is important in rtsa rehab. Stability and mobility of the shoulder joint is now. The intent of posting these standards of care and protocols is to provide clinicians and patients. 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 intent of this protocol is to provide the therapist with a guideline for the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head replacement, hhr. Total shoulder replacement postop physical therapy protocol.
It is not intended to be a substitute for special instructions from. Avoid exercises that put stress on the anterior shoulder capsule ie. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head. Typically this will need to be done multiple times a day, for 1520 minutes each time.
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 arthroplasty south shore orthopedics. Citations may include links to fulltext content from pubmed central and. Stability and mobility of the shoulder joint is now dependent upon the deltoid and periscapular musculature. Total shoulder arthroplasty rehabilitation protocol. In tsa, the current components of the glenoid are either a pegged or keeled highmolecular weight polyethylene cemented component. Department of rehabilitation services reverse total shoulder. Total shoulder arthroplastyhemiarthroplasty protocol. Rehabilitation after total shoulder arthroplasty dr. 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. Shoulder arthroplasty and reverse ball and socket arthroplasty limitations in. However, there is no consensus concerning the rehabilitation protocol following surgery. Lastly, patients will be expected to apply ice or cold packs to their shoulder on a regular basis.
Revision surgery or cases involving bonegrafting procedures may undergo modifications to the below guideline. Rehabilitation guidelines for shoulder arthroplasty and. 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. If superior performed, deltoid activity is contraindicated and the rehab protocol may be delayed. Reverse total shoulder replacement is performed for a variety of indications. The intent of this protocol is to provide the physical therapist with a guideline for the postoperative rehabilitation management for a patient who.
Use of a sling for 3 weeks postop unless otherwise indicated. Specific changes in the program will be made by the physician as appropriate for an individual patient. If you have questions, contact the referring physician. Reverse total shoulder arthroplasty rtsa rehabilitation protocol. Physical therapist jennifer petrakis demonstrates stages of rehabilitation you are likely to experience following a total shoulder replacement. Total shoulder arthroplasty tsa is indicated for patients with glenohumeral arthritis. Frozen shoulder repair rehab protocol mumford procedure rehab protocol rotator cuff repair rehab protocol shoulder arthroscopy rehab protocol shoulder impingement rehab protocol total shoulder. Variances will be communicated by the surgeon directly to rehabilitation services.
Pubmed comprises more than 26 million citations for biomedical literature from medline, life science journals, and online books. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a total shoulder arthroplasty tsa or hemiarthroplasty humeral head replacement, hhr. The intent of this protocol is to provide the therapist with a guideline for the postoperative rehabilitation course of a patient that has undergone a. Gentle closed kinetic chain shoulder and scapular stabilization drills wall ball circles and. The intent of this protocol is to provide the physical therapist with a guideline treatment protocol for the postoperative rehabilitation management for a patient who has undergone a reverse total. Postoperative rehabilitation protocols shoulder shoulder arthroscopy general slap or anterior labral repair posterior labral repair rotator cuff repair cc ligament reconstruction latarjet procedure pec. Total shoulder replacement protocol sports and orthopedic. Rehabilitation protocol for reverse shoulder arthroplasty. Total shoulder replacement rehabilitation guidelines. This protocol provides you with general guidelines for the postoperative rehabilitation of the patient following a total shoulder replacement. Reverse total shoulder replacement postoperative rehabilitation this protocol was developed for patients who have undergone a reverse total shoulder replacement. Reverse total shoulder arthroplasty for irreparable rotator. Rehabilitation protocol for total shoulder arthroplasty.
Uw health s sports medicine sports rehabilitation physical therapists and athletic trainers in madison, wisconsin, help injured athletes return to health and return to sport. Physical therapy standards of care brigham and womens. The path to regaining range of motion, strength and function can require a. This protocol was adapted from the articles titled. Begin flexion, ir, er, and elevation in scapular plane, submaximal painfree shoulder isometrics in neutral, progress scapular and distal extremity strengthening. Citations may include links to fulltext content from pubmed central and publisher web sites. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation.
The actual post surgical physical therapy management. Paff the intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone undergoing total. Rehabilitation following reverse total shoulder arthroplasty. The intent of this protocol is to provide the physical therapist with a guidelinetreatment protocol for the postoperative rehabilitation management for a. Rehabilitation guidelines for standard reverse total shoulder.