It is not intended to be a substitute for appropriate. Shoulder arthroplasty and reverse ball and socket arthroplasty. This is because the articular surface of the round humeral head is approximately four times greater than. Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. Total shoulder replacementtsa hemiarthroplastyhumeral head replacement hhr case type diagnosis. Reverse total shoulder arthroplasty clinical practice guidelines progression is time and criterionbased, dependent on soft tissue healing, patient demographics and clinician evaluation. Shoulder examination tests 15032020 diagnose your shoulder this is an interactive guide to help you find relevant patient information for your shoulder problem. Total ankle arthroplasty rehab protocol phase 1 maximum. Passive forward flexion, er, and ir in scapular plane, pendulum exercises, and arom of distal extremity. Physician incision approach is important in rtsa rehab.
Minimize heavy, excessive cyclic loads for the first 6 months. It is not intended to be a substitute for special instructions from. Department of rehabilitation services reverse total shoulder. Reduce pain, inflammation and muscular inhibition, increase prom of shoulder, allow healing of soft tissue. 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. After the surgery my shoulder hurt less than it did before without taking pain medication. Total shoulder replacement postoperative physical therapy protocol general considerations.
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. Rehabilitation appointments begin within 1 week of surgery. Variances will be communicated by the surgeon directly to rehabilitation services. Total shoulder replacement postop protocol 20191021t15. A schedule of total joint classes has been included in the front pocket of this guide and is also. Rehabilitation guidelines following total ankle arthroplasty. Erickson, md mackenzie lindeman, atc 176 3rd ave new york, ny 658 white plains rd tarrytown, ny 450 mamaroneck rd harrison, ny phone.
Use of a sling for 3 weeks postop unless otherwise indicated. Maintain surgical motion early, but protect subscapularis repair by avoiding. In this procedure the arthritic ball is replaced by a smooth metal ball fixed to the arm bone humerus by. Badman total shoulder replacement protocol phase i 03 weeks postop precautions x immobilizer on at all times, except during exercise and while showering x no shoulder rom except pendulums as instructed by dr. Elbow, wrist and hand mobility after your shoulder surgery, it is important to maintain full mobility of the joints below the affected shoulder.
I dont know why i waited so long in getting the procedure done. Rehabilitation following total shoulder arthroplasty reg b. This protocol is intended to guide clinicians and patients through the post operative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Hunt drive, suite 1100, charlottesville, va 22903 phone. Total shoulder replacement physical therapy protocols dr. Joint replacement sports medicine reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. Shoulder replacement rehabilitation program johns hopkins. This protocol was adapted from the articles titled.
This is because the articular surface of the round humeral head is. Total shoulder replacement oct 2009 sunnybrook hospital. Contact ohio state sports medicine at 6142932385 if questions arise. The first reported total shoulder arthroplasty was reported by a french surgeon named jules emile pean in 1893 for the purpose. During class you will receive useful information about your surgery and recovery. Specific interventions should be based on the needs of the individual and should consider exam findings. Do not move the arm away from body unless fully sup. You will also have the opportunity to ask questions. These rehabilitation guidelines are presented in a criterion based progression. Patients with rtsa dont dislocate with the arm in abduction and external. This protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty.
The first reported total shoulder arthroplasty was reported by a french surgeon named jules emile pean in 1893 for the purpose of treating tuberculous arthritis of the shoulder. Progression will be based on individual patient presentation, which is assessed throughout the treatment process. Do not move the arm away from body unless fully sup ported. Maintenance of good postural positioning when performing all exercises. Total shoulder replacement rehabilitation protocol range of motion immobilizer therapeutic exercise phase 1 06 weeks passive to active range of motion as tolerated rom goals. The typical total shoulder replacement involves replacing the arthritic joint surfaces with a highly polished metal ball attached to a stem, and a plastic socket. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. For a revision total hip arthroplasty additional limitations andor precautions may apply. Total shoulder replacement is a highly successful procedure to reduce pain and restore mobility in patients with endstage shoulder arthritis and, in some cases, after a severe shoulder fracture.
This protocol applies to the routine primary total hip arthroplasty procedure. When arthritis affects the shoulder it causes the lining of these. This protocol is intended to guide clinicians and patients through the postoperative course after a total shoulder arthroplasty tsa and hemiarthroplasty. Reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. Specific interventions should be based on the needs of the individual and. Dr badman performed a reverse shoulder replacement for me on september 17. Sling immobilization for first 46 weeksout of sling to do home exercise program pendulums twice daily. No shoulder rom no ip pt dislocation precautions patients following a rtsa do not dislocate with the arm in abduction and external rotation.
Total shoulder replacement is commonly performed and is generally a safe procedure. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder. Rehabilitation after total shoulder arthroplasty dr. Total shoulder arthroplasty protocol boston shoulder institute. 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.
Worn at all times day and night off for gentle exercise only 24 weeks. Patients, who have continued shoulder pain and loss of function in the. Total shoulder arthroplastyhemiarthroplasty protocol. 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 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. Sling is to be worn full time outside of the home and sleeping for 2.
Each case can be very different depending on the goals of the patient, the age of the. Rehabilitation protocol for total shoulder arthroplasty. Shoulder replacement surgery replaces damaged joint surfaces with artificial. There are a few significant differences in postoperative guidelines between a total shoulder arthroplasty tsa and. Reverse total shoulder arthroplasty rtsa rehabilitation protocol. The physician reserves the right to either advance or delay this protocol as deemed necessary. Department of rehabilitation services reverse total. Rehabilitation guidelines following total ankle arthroplasty rehabilitation is vital to regaining motion, strength and function of the ankle after surgery.
Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the shoulder. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. 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 arthroplastyhemiarthroplasty protocol cleveland. Microsoft word reverse total shoulder replacement protocol. Contact your surgical team to discuss specific parameters if you are having a revision surgery. Each case can be very different depending on the goals of. General time frames are given for reference to the average. A patients guide to total joint replacement and complete care. 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 components, commonly referred to as prosthesis.
Your shoulder is a ball and sockettype joint made up of two main parts. Rehabilitation program following humeral head replacement or total shoulder replacement 4 4. 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. Before suggesting the operation, your doctor will have considered that the benefits of having the operation outweigh any disadvantages. Rehabilitation protocol for total shoulder arthroplasty and. 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. Rehabilitation guidelines for shoulder arthroplasty and. 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 hemiarthroplasty protocol.
Rehabilitation protocol for reverse shoulder arthroplasty. Total shoulder replacement arthroplasty for shoulder arthritis total shoulder replacement arthroplasty is a wellestablished surgery for restoring comfort and function to the arthritic shoulder. I had shoulder pain in both shoulders for many years. Total shoulder replacement protocol sports and orthopedic. Sling worn continuously for 34 weeks, no shoulder arom, no lifting of objects. Stability and mobility of the shoulder joint is now dependent upon the deltoid and periscapular musculature. Total shoulder replacement rehabilitation guidelines. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint. Rehabilitation following total shoulder arthroplasty. The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation. Sling is to be worn full time outside of the home and sleeping for 23 weeks, prn in the home may vary by m. 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. There is a higher risk of shoulder dislocation following a reverse total shoulder arthroplasty rtsa than with conventional shoulder replacement. 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.
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