Rotator cuff repair protocol south shore orthopedics. 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. Standard open or arthroscopic rotator cuff repair protocol. An abduction splint which holds the arm away from the body. We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. Often there is a bone spur in this region that can pinch against the rotator cuff or bursa fluid filled sac. This protocol applies to most cases, some variations will occur depending on the. It is not intended to be a substitute for ones clinical decision.
If you have any questions regarding the progress of the patient, the. However, the purpose of subacromial decompression procedure is not clearly explained. Arthroscopic subacromial decompression request pdf. After the first day or two, as the pain lessens, you may decrease the frequency with which you take the medication. If initial nonsurgical treatment of a rotator cuff tear fails, surgical repair is often the next line of treatment.
Subacromial decompression rotator cuff debridement biceps tenodesis phase i. After arthroscopic subacromial decompression intact. This protocol provides you with general guidelines for the rehabilitation of patients following a standard open, mini open andor arthroscopic rotator cuff repair. Subacromial decompression and distal clavicle excision understanding shoulder anatomy the shoulder is a large ball and socket joint. The surgical management of irreparable rotator cuff tears includes a number of procedures with varying degrees of complexity. After subacromial decompression and cuff repair there is particular concern with the following types of problems. Radiographic assessment of scapular rotational tilt in chronic shoulder impingement syndrome. This article contains details about these and other surgical treatments commonly used for rotator cuff tears. This is because the articular surface of the round humeral head is approximately four times greater than that of the. After arthroscopic subacromial decompression andor. Arthroscopy with subacromial decompression andor distal clavicle resection without rotator cuff repair dr. Post operative arthroscopic subacromial decompression protocol. Passive, aarom, and arom exercises as symptoms allow starting with passive. Patients undergoing arthroscopic rotator cuff repair or subacromial decompression by the senior surgeon were prospectively identified and offered participation in the research study.
Sports medicine physical therapy rehabilitation protocols. Surgery to repair a torn rotator cuff most often involves reattaching the tendon to the head of humerus upper arm bone. Bicep tenodesis rehabilitation protocol range of motion sling exercises phase i 04 weeks prom as tolerated 06 weeks. Restrictions rom 140 degrees of forward flexion 40 degrees of external rotation 60 degrees of abduction rom exercises begin with the arm comfortably at the patients side, progress to. After arthroscopic subacromial decompression andor partial rotator cuff debridement. Arthroscopic subacromial decompression protocol sports and.
This protocol provides you with general guidelines for the rehabilitation of a patient following an arthoscopic subacromial decompression sad. This protocol is designed for the patient following arthroscopic rotator cuff repair. The socket portion of the joint is not naturally deep. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. A partial tear, however, may need only a trimming or smoothing procedure called a debridement. Post operative arthroscopic subacromial decompression protocol the intent of this protocol is to provide the clinician with a guideline for the postoperative rehabilitation course of a patient that has undergone an arthroscopic subacromial decompression. General time frames are given for reference to the average, but individual patients will progress at. Decompression surgery can involve one or both of these procedures. Do not add, alter, or skip any of the treatments in this protocol. Sad subacromial decompression protocol phase i postop until week 2 protective phase. Our reaserch aimed to analyse the differences among the outcomes of arthroscopic rotator cuff repair rcr made with suture anchors, with or without the subacromial decompression procedure. Arthroscopic cuff repairsubacromial decompression name dos.
Rehabilitation guidelines for type i and type ii rotator. Subacromial decompression, arthroscopic debridement, acromioplasty, distal clavical excision, slap i debridment rehabilitation protocol. Those patients with poor rotator cuff tissue integrity, tear of 2. Arthroscopic rotator cuff repair frequently asked questions. The shoulder is a wonderfully complex joint that is made up of the ball and socket connection between the humerus ball and the glenoid portion of the scapula socket. Arthroscopic rotator cuff repair with and without acromioplasty in the treatment of fullthickness rotator cuff tears.
Kaar, md department of orthopaedic surgery sports medicine and shoulder service subacromial decompression partial thickness rotator cuff tear debridement distal clavicle excision rehab protocol prescription patient name. Patients who have undergone concomitant repair of a rotator cuff tear, biceps. The intent of posting these standards of care and protocols is to provide clinicians and patients. It is not intended to be a substitute for clinical decision making regarding the progression of a patients postoperative course based. Post operative arthroscopic subacromial decompression.
It explains the benefits, risks and alternatives to the procedure, as well as what you can expect when. The subacromial decompression should improve pain, but movement and strength may be no better. Rehabilitation guidelines for shoulder arthroscopy uw health. Stone invented one of the first suture anchors designed for rotator cuff repair, the questis suture anchor, and has been involved in technique design, modifications, and improvements ever since. Rotator cuff repair rehab protocol the stone clinic. Start against gravity and gradually progress with weights. Exclusion criteria included a fullthickness torn rotator cuff. Page 2 page 3 rotator cuff repair this information booklet has been produced to help you gain the.
Before undergoing subacromial decompression surgery your doctor will discuss the recovery. Postoperative instructions for shoulder arthroscopy with. The rotator cuff keeps the humeral head ball inside the glenoid cavity socket during shoulder motion. Rehabilitation guidelines for shoulder debridement. Wound care as outlined on the shoulder arthroscopy rehabilitation page. The sports physical therapy service is an integral part of the sports medicine center and the department of. In a normal shoulder the subacromial space is about 9 to 10 millimeters high. You will be sent home from the surgery center with prescriptions for pain medication.
The therapist can provide instruction on patient directed active range. Subacromial decompression protocol south shore orthopedics. Rehabilitation guidelines for type i and type ii rotator cuff repair and isolated subscapularis repair the anatomic configuration of the shoulder joint glenohumeral joint is often compared to that of a golf ball on a tee. The program is based on muscle physiology, biomechanics, anatomy, and healing response. Subacromial impingement occurs when the rotator cuff tendons andor bursa become trapped between the acromion and the humerus with overhead motion of the. The intent of this protocol is to provide the clinician with a guideline of the postoperative. Sutures will be removed in the clinic at 1 st postoperative appointment 1014 days after surgery. Exercises versus arthroscopic decompression in patients with subacromial impingement. Large rotator cuff repair protocol the intent of this protocol is to provide the clinician with instruction, direction, rehabilitative guidelines and functional goals for all rotator cuff repair procedures. After arthroscopic subacromial decompression intact rotator cuff distal clavicle resection rehabilitation protocol. Days 1 to 14 office visit to have a dressing changed, one to two days postop cryotherapy as needed to control pain and swelling. Physical therapy standards of care brigham and womens.
The subacromial decompression should improve pain, but movement and strength. 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 subacromial decompression. Subacromial decompression, arthroscopic debridement. With a range of tear characteristics such as chronicity, degree of fatty atrophy, and number of tendons involved as well as varying patientspecific characteristics including age, injury mechanism, and expectations after treatment to consider, proper and successful treatment of a rotator cuff tear is multifactorial and, consequently, challenging. Macdonald p, mcrae s, leiter j, mascarenhas r, lapner p. A subacromial decompression is an arthroscopic procedure performed when an instrument is used to remove some bone on the undersurface of the acromion to create more space for the rotator cuff tendons figures 4 and 5.
Specific changes in the program will be made by the physician as appropriate for an individual patient. Request pdf arthroscopic subacromial decompression in this study, we analyzed the results of two series of patients treated for impingement syndrome by undergoing arthroscopic subacromial. Those patients who have good rotator cuff tissue integrity, a one to two tendon repair, with a tear 3 centimeters or less will typically be progressed on the quicker end of these time frames. Progress of rotator cuff free weight program independently. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Denards rehabilitation protocols arthroscopic shoulder surgery. It is no means intended to be a substitute for ones clinical decision making regarding the progression of a. The intent of this protocol is to provide guidelines for progression of rehab. For this reason the shoulder is the most mobile joint in the body.
This rehabilitation programs goal is to return the patientathlete to activitysport as quickly and safely as possible. Arthroscopic cuff repairsubacromial decompression orthovirginia. Understanding the subacromial decompression and distal. Arthroscopic subacromial decompression boston shoulder institute. Shoulder rotator cuff repair oxford university hospitals.
The intent of this protocol is to provide the clinician with a guideline of the post. Find pdfs of our most common rehabilitation protocols. Develop and maintain full pain free range of motion rom of the shoulder. Subacromial decompression andor distal clavicle excision.