If you have questions, contact the referring physician. Reverse shoulder arthroplasty rsa shows a growing number of implantations and is a valuable option to improve shoulder function and decrease pain. Allow involved arm to hang down, perpendicular to the floor. However, there is no consensus concerning the rehabilitation protocol following surgery. Revision surgery or cases involving bonegrafting procedures may undergo modifications to the below guideline. Appointments physical therapy 23 xweek rehabilitation goals promote soft tissue healingmaintain the integrity of the replaced joint restore arom of elbow, wrist, and hand precautions. 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 rtsa is indicated for patients with. Variances will be communicated by the surgeon directly to rehabilitation services. Rehabilitation protocol for reverse shoulder arthroplasty. Many patients with reverse total shoulder replacements can elevate their arm above shoulder level. No shoulder rom no ip pt dislocation precautions patients following a rtsa do not dislocate with the arm in abduction and external rotation. Shoulder arthroplasty and reverse ball and socket arthroplasty are two surgical options for replacing the articular surfaces of the humeral head and glenoid.
Patients, who have continued shoulder pain and loss of function in the. 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. There are a few significant differences in postoperative guidelines between a total shoulder arthroplasty tsa and reverse shoulder arthroplasty rsa primarily due to. General time frames are given for reference to the average. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Reverse total shoulder replacement postop protocol. 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 exercises. 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. 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. Shoulder hemiarthroplasty physical therapy protocol phase i. Total shoulder replacement physical therapy protocols dr. Continue above exercises, scapular isometrics, aarom of shoulder flexion, er, and ir in scapular plane. For patients who are recovering from shoulder surgery, please refer to the following protocols as advised by your physical therapist. The material on this website is designed to support, not replace, the relationship that exists between ourselves and our patients.
Shoulder hemiarthroplasty physical therapy protocol. 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. This protocol will vary in length and aggressiveness depending on factors such as. Each case can be very different depending on the goals of the patient, the age of the. The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. To achieve this, healthcare providers will follow total shoulder replacement protocol to completely remove the damaged parts of your shoulder, including the shoulder joint, and replace them with artificial. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Rehabilitation protocol for total shoulder arthroplasty. 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. Total shoulder arthroplasty tsa is indicated for patients with glenohumeral arthritis. The rotator cuff is either absent or minimally involved with the rtsa. Rehab protocols arthroscopic superior capsular repair.
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. Sling to be worn at all times except while doing exercises for 6 weeks, unless. Jennifer penrose important rehab guidelines to consider avoid shoulder ext past neutral for 12 weeks. This protocol is intended to guide clinicians and patients through the post operative course after a total shoulder arthroplasty tsa and hemiarthroplasty. 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. The goal of this protocol is to slowly advance range of motion and strength while avoiding dislocation of the shoulder replacement. Rehabilitation guidelines for standard reverse total. Total shoulder replacement postop protocol this protocol is intended to be a general outline only. If you suffer a shoulder injury that results in severe discomfort or extensive damage, your physician may recommend total replacement shoulder surgery. The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family. It is by no means intended to be a substitute for a physical. Total hip arthroplasty tha is an elective operative procedure to treat an arthritic hip. Rehabilitation following total shoulder arthroplasty.
Reverse total shoulder arthroplasty rehab protocol 1 rehabilitation guidelines for standard reverse total shoulder arthroplasty rtsa note. 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. 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. 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. Specific interventions should be based on the needs of the individual and. Rehabilitation guidelines for shoulder arthroplasty and reverse. This site complies with the honcode standard for trustworthy health information.
Rehabilitation protocols ohio state sports medicine. Reverse total shoulder arthroplasty protocol 1 brigham and. Keep the elbow of the operated arm against your side with the elbow bent 90 degrees. The performance of the procedure is complete, but for the most optimal outcome, it is vital that you follow your post operative rehabilitation protocol. This protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Dr brian badman offers arthroscopic superior capsular repair in carmel, fishers, terre haute, kokomo, brownsburg and franklin in indiana. Total shoulder arthroplasty rehab protocol physical therapy haven.
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 shoulder and elbow. Please note that this is advisory information only. Total shoulder arthroplastyhemiarthroplasty protocol. Physical therapy standards of care and protocol the following standards of care and protocols are the property of bwh and should not be copied or otherwise used without the permission of the director of rehabilitation services.
The rehabilitation program will gradually progress to more strengthening and control type exercises. The physician reserves the right to either advance or delay this protocol. In shoulder arthroplasty the humeral head ball is replaced with metal and the glenoid tee is replaced with a plastic liner. Please note these are meant to be guidelines for rehabilitation to be followed by a certified physical or occupational therapist.
This protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. This evidencebased total shoulder arthroplasty guideline is. 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. Rehabilitation following total shoulder arthroplasty reg b.
Shoulder replacement rehabilitation program johns hopkins. The intent of this protocol is to provide the clinician with a. Rehabilitation after total shoulder arthroplasty dr. Shoulder replacement surgery replaces damaged joint surfaces with artificial. Rehabilitation following reverse shoulder arthroplasty. Pendulum exercises bend forward at the waist, back parallel to ground is ideal. Shoulder arthroplasty protocol northeast orthopedics and. Rehabilitation after total shoulder arthroplasty supine external rotation. Paff the intent of this protocol is to provide the clinician with guidelines of the postoperative rehabilitation of someone under going total shoulder arthroplasty or hemiarthroplasty. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful.
Rehabilitation guidelines for shoulder arthroplasty and. Ohio state physicians and physical therapists work collaboratively to develop best clinical practices for postsurgical rehabilitation. Department of rehabilitation services reverse total. To serve as a guide to physical therapy following your surgery, this section contains rehabilitation protocols specific to your procedure. Rehabilitation protocol for total shoulder arthroplasty and. This procedure replaces your damaged hip joint with an artificial hip implant. Rehabilitation guidelines royal national orthopaedic. Maintenance of good postural positioning when performing all exercises. The gundersen health system rehabilitation programs are evidencebased and soft tissue healing dependent programs designed to allow patients to progress to vocational and sportrelated activities as quickly and safely as possible. Total shoulder arthroplasty rehabilitation guideline sanford health. Physical therapy standards of care brigham and womens. All exercises must be demonstrated to a patient by a fully qualified physiotherapist. 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. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint.
Avoid internal rotation, adduction and extension as patients have a high likely hood of. Presence of a functional rotator cuff intact or repaired type of shoulder replacement anatomic or reverse. Begin flexion, ir, er, and elevation in scapular plane, submaximal painfree shoulder. 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. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty. Minimize heavy, excessive cyclic loads for the first 6 months. Shoulder arthroplasty protocol shoulder arthroplasty protocol this rehabilitation protocol has been developed for the patient following a shoulder arthroplasty replacement procedure. Use of a sling for 3 weeks postop unless otherwise indicated. The shoulder arthroplasty procedure is performed to improve function, increase active range of motion and reduce pain of the shoulder. Total shoulder arthroplasty protocol boston shoulder institute. Reverse total shoulder replacement rehabilitation guidelines. Using a cane or a long stick in the opposite hand, push against the hand of the operated arm so that the operated arm rotates outward.
Total shoulder arthroplasty hemiarthroplasty protocol. 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. Rehabilitation guidelines after surgery, sports medicine. 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. Reverse shoulder replacement delta3 rotator cuff repair. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. This protocol was adapted from the articles titled.
11 293 197 911 568 91 146 377 955 1076 681 667 493 974 904 14 283 486 93 641 812 1527 114 839 430 381 1161 752 1105 242 16 72 203 696 343 442 194 1322 655 239 965