A reverse total shoulder replacement works better for people with cuff tear arthropathy because it relies on different muscles to move the arm. Anatomy of the shoulder joint this movie is an educational resource only and should not be used to make a decision on shoulder arthroscopy. A hemiarthroplasty replaces the humeral head only, and is the treatment of. 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 semiconstrained reverse shoulder prosthesis, designed by grammont in the. They may be either cemented or press fit into the bone.
Good candidates for shoulder arthroplasty are older patients who will place minimal demands on the shoulder and have no rotator cuff damage. A complete total shoulder system with the intraoperative flexibility to address multiple glenohumeral disease states from a single stem platform. The increase of shoulder replacements will lead to a higher revision rate of shoulder arthroplasties. 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. Total shoulder replacement rehabilitation guidelines.
Total shoulder replacement protocol sports and ortho. Such as tucking in their shirt, and performing bathroom personal hygiene. Total shoulder replacement reverse total shoulder replacement adopted 298, revised 904, revised 809 1 general principles. In these procedures the subscapularis is detached for exposure of the glenohumeral joint and then reattached after the repair is complete. The surgeon reverses the normal anatomy in an attempt to give the patient pain relief and increase functional mobility of the arm. 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.
Each case can be very different depending on the goals of the patient, the age of the. Citescore values are based on citation counts in a given year e. Total shoulder arthroplasty hemiarthroplasty protocol. Arthrography with contrast to confirm integrity of the rotator cuff if there is a clinical question about the cuff integrity. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the glenohumeral joint. It is not intended to be a substitute for appropriate clinical decision making regarding the progression of a patients rehab. Contact ohio state sports medicine at 6142932385 if questions arise. Stemless shoulder arthroplasty systems with uncemented metaphyseal fixation have been. Tid until their first pt visit supine cane prom flexion sitting or standing prom cane er to neutral. It features a true anatomical reconstruction latitude total elbow prosthesis of the joint, modular components, and is adaptable to a wide range of indications. Difference in clinical outcome between total shoulder. Recent journal of shoulder and elbow surgery articles.
Reverse total shoulder replacement is a surgery performed to improve shoulder function and decrease pain. You should also be aware that shoulder replacement is associated sometimes with nerve injury to the nerve that moves the arm. Digital imaging and communications in medicine files of each ct scan. Rehabilitation after total shoulder arthroplasty activities and advice for in the hospital and while at home. As the covid19 situation progresses, all northern arizona healthcare facilities have enacted restricted visiting guidelines. Total shoulder arthroplastyhemiarthroplasty protocol. A conventional replacement device also uses the rotator cuff muscles to function properly. Avoid internal rotation, adduction and extension as patients have a high likely hood of dislocation with combined movements. Tornier shoulder prostheses university of washington. Onset of shoulder pain is variable and can occur with no direct cause, or it can be related to trauma, repetitive movements, or a neurological event i. 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. It is not intended to be a substitute for appropriate. Compactor overview the aequalis ascend flex convertible shoulder system offers both short and long stems and therefore offers both short and long compactors. When it comes to the best exercise with the best range of motion for shoulder muscles, arnold press stands out from the crowd.
View and download powerpoint presentations on total shoulder arthroplasty ppt. The latitude total elbow is the first 3rd generation elbow prosthesis. Problems, complications, reoperations, and revisions in reverse total. Tip squeeze your shoulder blades together when you pull your elbow back. Rehabilitation program following reverse total shoulder replacement 3 regular sling the regular sling is designed to keep your operated shoulder in a comfortable position after your surgery. Version and inclination obtained with 3dimensional planning in. Difference in clinical outcome between total shoulder arthroplasty tsa and reverse shoulder arthroplasty rsa used in revision surgery in 21 shoulders at an. This procedure is performed on patients who have suffered massive rotator cuff tears, which have led to a painful condition known as rotator cuff tear arthropathy, or on those patients who have undergone previously failed shoulder surgeries.
Reverse total shoulder replacement postop protocol. 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. Continue exercises in previous phase as needed continue to progress shoulder prom limiting er to 20 degrees shoulder aarom with pulleys shoulder flexion passive flexion counter slide bowing shoulder wall slidewalk aarom exercises with straight cane all motions to tolerance flexion. With a revtsr, the muscles that stabilize your shoulder rotator cuff are no longer used. Underlying diagnoses include rheumatoid arthritis, osteoarthritis, trauma, or tumor. This surgery almost always reduces joint pain and improves your quality of life. Wright upper extremities wright medicals shoulder, hand, forearm, and elbow products are chosen by surgeons around the world.
Designed to enhance primary fixation conical central post and 4 peripheral screws and secondary fixation ha coating. The sling is worn for comfort for approximately 34 weeks. Within the web application, navigate to and click on dicom upload from the lefthand menu. You may place a ball or some socks between your elbow and body to help you hold your arm by your side. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Patientreported outcome after stemmed versus stemless total.
Apply ice, or the cooling unit, to the shoulder as it will be quite helpful. Full length article volume 2, issue 4, p200204, december 01, 2018. Altru advanced orthopedics total shoulder arthroplasty. All decisions about arthroscopy must be made in conjunction with your surgeon or a licensed healthcare provider. Shoulder stretching exercises 2010 3 supine external rotation lying on your back, use a stick, cane, or golf club to push your affected arm into external rotation.
Short stems are offered in three anatomic angles a127. Reverse total shoulder arthroplasty clinical practice guidelines progression is time and criterionbased, dependent on soft tissue healing, patient demographics and clinician evaluation. Ct scan for the most accurate assessment of glenoid version. Reverse total shoulder arthroplasty protocol weeks allow healing of soft tissue, monitor neurovascular status independent with adls with modifications to protect joint replacement. This protocol was adapted from the articles titled. Speedbridge subscapularis repair for stemless eclipse total shoulder arthroplasty. In a healthy shoulder, the rotator cuff muscles help position and power the arm during range of motion. The shoulder has a greater range of motion than any other joint in our body, but because it can perform so many movements, the shoulder is vulnerable to stress, injury, and arthritis. Soft tissue balancing in total shoulder replacement.
Before your surgery you will most likely arrive at the hospital on the morning of the surgery. Shoulder patient forms johns hopkins shoulder and elbow. Access and print shoulder patient forms, discharge instructions, surgery device instructions and rehabilitation protocols written by johns hopkins expert shoulder surgeons. Find powerpoint presentations and slides using the power of, find free presentations research about total shoulder arthroplasty ppt. The actual therapy plan of care must be based on the surgical approach, physical exam and findings.
A total shoulder arthroplasty involves the replacement of both sides of the glenohumeral joint the humerus and the glenoid. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making. Total shoulder and reverse total shoulder replacement. Shoulder pain introduction shoulder pain is typically characterized by symptoms in the various joints, muscles, tendons, and bursa involved with shoulder motion. The latitude total elbow is designed to reproduce the patients anatomy. Arnold shoulder press is an excellent shoulder muscle building exercise. Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the shoulder. Rehabilitation guidelines for shoulder arthroplasty and. Total shoulder arthroplasty protocol twin cities orthopedics. This sling should be removed for bathing, dressing and exercising. Total shoulder arthroplasty tsa has become a commonplace and accepted management for the arthritic shoulder, in both young 36 and old. During total shoulder replacement surgery, your damaged shoulder joint is replaced with an artificial joint called a prosthesis.
Stability and mobility of the shoulder is now dependent on the deltoid and periscapular. However, functional outcomes are determined by many factors including variable expectations with the young having higher than the old, anatomic factors such as glenoid erosion and accurate. Sling is to be worn full time outside of the home and sleeping for 23 weeks, prn in the home may vary by m. It is very important to keep your elbow by your side while doing this.
Total shoulder arthroplasty, or joint replacement, is indicated when pain, instability, or limitations in rom interfere with a patients ability to perform functional tasks. Home educational resources videos surgical technique the univers ii. It gives a wide range of motion as you lower the dumbbells well down in front giving that maximum stretch other shoulder exercises lack. The aim of this study is to evaluate the clinical results of revision surgery performed in our hospital, distinguish the differences in clinical outcome according to revision indication and differences between total shoulder arthroplasty tsa and reverse shoulder. Total shoulder replacement us sample marketresearch. Rehabilitation following total shoulder arthroplasty. Learn more if you have questions about covid19 exposure, transmission andor testing, contact the northern arizona healthcare coronavirus hotline at 9287732301 or 18337080894. Titan reverse shoulder systems surgical technique integra. The versadial humeral head prosthesis is intended for use only with the comprehensive shoulder stems. Should this happen, you can lose some function of your arm or hand. Total shoulder arthroplasty protocol jason dieterle, do preoperative visit. Patients, who have continued shoulder pain and loss of function in the. Started 15 years ago in the late 90s, at that time.