Continue with previous exercises and add exercises below. Reverse shoulder replacement and postop exercises youtube. This combination of conditions can result in major loss of stability and active motion of the shoul. The rounded end of the upper arm bone moves inside a shallow socket in. The most common indications are rotator cuff tear arthropathy. There is a higher risk of shoulder dislocation following a reverse total shoulder arthroplasty rtsa than with conventional shoulder replacement.
The primary objective of this study is to compare outcomes between formal clinic based physical therapy pt rehabilitation and surgeon directed home therapy ht after reverse total shoulder arthroplasty rsa as measured by pain, range of motion, single assessment numerical evaluation sane, and american shoulder and elbow surgery ases scores at 6 weeks, 3, 6, 12, and 24 months. Reahabilitation following reverse total shoulder arthropoplasty. Sling immobilization for 6 weeks except for bathing and therapeutic exercises goals. Frederick matsen, uw medical center orthopedic surgeon, discusses a new and innovative shoulder replacement surgery featuring a reverse ballsocket technique that can lessen pain and improve function in shoulders with failed surgery or combined arthritis, rotator cuff tears and instability issues. Active assisted exercises into flexion as tolerated table slides to wall slides walks. Reverse total shoulder replacement sunnybrook hospital. Total shoulder and reverse total shoulder replacement. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint. Oct 15, 2019 reverse total shoulder replacement is a great option for patients who have arthritis in the shoulder as well as a rotator cuff tear. 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. Reverse total shoulder arthroplasty provides a surgical alternative to standard total shoulder arthroplasty for the treatment of selected complex shoulder problems. After your recovery, these exercises can be continued as a maintenance. Physical therapy for reverse total shoulder replacement this handout has information about your reverse total shoulder replacement and the exercises you will need to do after your surgery. Sling is worn for 34 weeks postoperatively and only removed for exercise and bathing.
Sling is to be worn full time outside of the home and sleeping for 2. A conventional shoulder replacement device mimics the normal anatomy of the shoulder. Home exercise program after reverse total shoulder. Rehabilitation following reverse total shoulder arthroplasty. Deltoid function and periscapular strength become primary sources of shoulder mobility and stability. This is because the articular surface of the round humeral head is approximately four times greater than. Adduction holding on to the end of the wand with the right hand, right elbow slightly flexed, left hand is on the mid shaft on the wand and pulls right shoulder across the body for exercising an involved right shoulder, reverse hands for an. Rehabilitation protocol for reverse shoulder arthroplasty.
Patients, who have continued shoulder pain and loss of function in the. The implant is designed so that the ball portion is attached to the scapula and the socket is placed at the upper end of. Rehabilitation following total shoulder arthroplasty. Rehabilitation guidelines for shoulder arthroplasty and reverse. Isotonic strengthening exercises should be encouraged 12xweek for 36 months b. Rtsa is indicated when there is a combination of a.
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. Each case can be very different depending on the goals of the patient, the age of the. Exercises for recovery from total shoulder replacement. This shoulder conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. In the hands of an experienced surgeon, the reverse total shoulder can be an effective method for treating. Reverse total shoulder arthroplasty protocol 1 boston shoulder. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation.
There are a few significant differences in postoperative guidelines between a total shoulder arthroplasty tsa and reverse shoulder arthroplasty rsa primarily due to rotator cuff arthropathy. In a reverse total shoulder replacement, the socket and metal ball are switched. Reverse total shoulder arthroplasty chicago rotator cuff. Reverse total shoulder replacement johns hopkins shoulder. Patient demonstrates proper shoulder mechanics references bourdreau s, bourdreau e, higgins ld, and wilcox rb. Reverse total shoulder replacement is the type of shoulder replacement used for people with combined shoulder arthritis and a large tear in the rotator cuff. Physical therapy for reverse total shoulder replacement. Rehabilitation following total shoulder arthroplasty reg b. Rehabilitation guidelines for standard reverse total. Supine exercises should be done with a small rolled towel placed behind the elbow to avoid shoulder hyperextension and anterior capsular stretch. Rehabilitation guidelines for reverse total shoulder.
Reverse total shoulder replacement johns hopkins medicine. Reverse shoulder replacement uw orthopaedics and sports. Patient is able to maintain painfree shoulder arom typically 80120 of elevation, with functional er of about 30 2. Stability and mobility of the shoulder is now dependent on the deltoid and periscapular. If superior performed, deltoid activity is contraindicated and the rehab protocol may be delayed. The surgeon reverses the normal anatomy in an attempt to give the patient pain relief and increase. 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. This handout has information about your reverse total shoulder replacement and the exercises you will need to do after your surgery. To strengthen your shoulder, you may do the following during this time. Nov 21, 2018 exercises for patient with reverse total shoulder arthroplasty 46 weeks postoperative protocol driven. Home exercise program after reverse total shoulder arthroplasty most patients using a home exercise program should perform their exercises 34 times per day, performing three sets of ten repetitions. Total shoulder or reverse shoulder arthroplasty phase i.
Your new shoulder pieces fit together like your natural shoulder, with the ball in the socket. To protect, repair and maintain your range of motion, it is. Reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. Continue to avoid shoulder ir adduction and cross body encourage proper shoulder mechanics and avoid repetitive active motion exercises no lifting more than 5 lbs. Reverse total shoulder your surgeon might opt to perform a reverse total shoulder replacement revtsr if your rotator cuff is severely torn and the joint is affected by arthritis. Patient was just approved to have sling removed and is weightbearing as tolerated with the. Shoulder examination tests 15032020 diagnose your shoulder this is an interactive guide to help you find relevant patient information for your shoulder problem.
The reverse total shoulder can restore comfort and function to shoulders with arthritis and massive defects in the rotator cuff or in failed conventional total shoulder replacement. Sling is to be worn full time outside of the home and sleeping for 23 weeks, prn in the home may vary by m. 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. Resume functional activities as allowed by the physician this protocol provides you with general guidelines for the rehabilitation of the patient with a reverse total shoulder replacement. Elbow, wrist and hand mobility after your shoulder surgery, it is important to maintain full mobility of the joints below the affected shoulder. A reverse total shoulder replacement is a special type of shoulder surgery. This is because the articular surface of the round. Reverse total shoulder protocol precautions no shoulder motion behind lower back. It is not intended to be a substitute for ones clinical decision making. Pulley exercises hang your pulleys over a door and face the door. 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. Reverse total shoulder replacement postop protocol. Rehabilitation guidelines for standard reverse total shoulder.
Continue to protect the repair by avoiding excessive forceful use of the arm or lifting excessively heavy weights. 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. Exercises for patient with reverse total shoulder arthroplasty 46 weeks postoperative protocol driven. 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 reverse total shoulder replacement can restore comfort and function to the arthritic shoulder combined with a massive rotator cuff tear and for failed conventional total shoulder replacement. Department of rehabilitation services reverse total. Reverse total shoulder replacement postop protocol penrose. Patients are usually in the hospital for less than 24 hours and. Reverse or inverse total shoulder arthroplasty rtsa is designed specifically for the treatment of glenohumeral gh 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 tsa in which the rotator cuff tendons are. Reverse total shoulder replacement therapy protocol general information.
Rehabilitation after reverse shoulder arthroplasty out of the socket, and. Reverse total shoulder replacement postoperative rehabilitation this protocol was developed for patients who have undergone a reverse total shoulder replacement. Reverse total shoulder replacement is performed for a variety of indications. Patients should be advised to always be able to visualize their elbow while lying supine. Such as tucking in their shirt, and performing bathroom personal hygiene. It is not intended to be a substitute for special instructions from. Rehabilitation after reverse total shoulder replacement phase 4. Home exercise program after reverse total shoulder arthroplasty. The reverse, or inverse total shoulder arthroplasty is usually used for patients with arthritis.
Arthroplasty tsa in which the rotator cuff tendons are deficient. Anterior posterior radiography of a right shoulder a and an illustration of a left shoulder b after reverse total shoulder. Early post surgery rehab first 6 weeks after surgery. Leave the steristrips on the incisions until one week after your surgery. Physical therapy for reverse total shoulder replacement 3 months after surgery.
Reverse total shoulder arthroplasty with the reverse shoulder prosthesis, the anatomy, or structure, of the healthy shoulder is reversed. Oct 25, 2018 the primary objective of this study is to compare outcomes between formal clinic based physical therapy pt rehabilitation and surgeon directed home therapy ht after reverse total shoulder arthroplasty rsa as measured by pain, range of motion, single assessment numerical evaluation sane, and american shoulder and elbow surgery ases scores at 6 weeks, 3, 6, 12, and 24 months. Rehabilitation program following reverse total shoulder replacement 4 4. Reverse total shoulder replacement rehabilitation guidelines. Rehabilitation guidelines for shoulder arthroplasty and. Reverse total shoulder replacement university of maryland. It surgeon a doctor to remove the damaged parts of the shoulder and replace them with artificial parts.
Avoid internal rotation, adduction and extension as patients have a high likely hood of dislocation with combined movements. Shoulder arthroplasty and reverse ball and socket arthroplasty. Home exercise vs pt for reverse total shoulder arthroplasty. Reverse total shoulder arthroplasty components zimmer, warsaw, in.
Department of rehabilitation services reverse total shoulder. Reverse or inverse total shoulder arthroplasty rtsa is designed specifically for the. Reverse total shoulder exercises 46 wks post operative. Rehabilitation after reverse 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.
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 criteria criteria for discharge from skilled pt. Restore shoulder strength to allow activities of daily living 4. Rehabilitation appointments begin within 1 week of surgery. The shoulder joint is made up of the upper arm bone humerus and the shoulder blade scapula. The use of a sling often may be extended for a total of 6 weeks, if the current procedure is a revision surgery. Reverse total shoulder arthroplasty rtsa rehabilitation protocol. Reverse total shoulder replacement is a complex procedure and is warranted by certain conditions. Maximizing your new shoulder university of florida. The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket.
52 422 58 797 736 1293 341 487 636 330 1353 846 152 286 1199 1421 1162 1203 1459 668 763 738 335 560 1070 732 389 245 1180 1102 22 583 121 1318 1024 1023 1038