Reverse total shoulder arthroplasty radiology reference. The deltoid has an improved mechanical advantage to move the arm, enabling the artificial joint to function better by compensating for the torn rotator cuff. It is by no means intended to be a substitute for a physical. Rehabilitation guidelines for shoulder arthroplasty and. Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the. This operation is also called reverse arthroplasty. Shoulder arthroplasty and reverse ball and socket arthroplasty limitations in. Reverse shoulder replacement university hospitals birmingham. Range of motion prom aarom arom increase as tolerated o begin active internal rotation and backward. Protocol reverse polarity shoulder arthroplasty introduction the reverse shoulder replacement changes the orientation of the shoulder, changing the mechanics of the shoulder. Rehabilitation after reverse shoulder arthroplasty out of the socket. Single surgeon experience with a minimum 2year followup. 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. It is not intended to be a substitute for special instructions from.
Please apply by visiting the unit and sending your cv to jan barker visits to the reading shoulder unit are welcome please liaise with prof. If you have a manual job, or one that involves lifting, you may. Progression to the next phase based on clinical criteria and time frames as appropriate. 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. Reverse polarity total shoulder replacement rptsr is an operation to treat arthritis of the shoulder with pain, associated with massive irreparable tears in the tendons rotator cuff around the shoulder. Rehabilitation guidelines for shoulder arthroplasty and reverse. 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. The deltoid has an improved mechanical advantage to move the arm, enabling the artificial joint to function when. The current neer protocol for postoperative tsa rehabilitation is widely used and.
This protocol provides you with general guidelines for the rehabilitation of the patient with a reverse total shoulder replacement. Reverse polarity total shoulder replacement mr s vollans. Reverse total shoulder replacement postoperative rehabilitation this protocol was developed for patients who have undergone a reverse total shoulder replacement. Biomechanics of the aequalis reversed ii prosthesis is designed for medialization of the center of rotation inside the glenoid bone surface.
Reverse total shoulder arthroplasty shoulder replacement. Therefore, reverse shoulder replacement is a good option for taking care of this complicated problem. Reverse total shoulder replacement johns hopkins shoulder. The patient is placed into the beachchair position and the arm is prepped and draped free in standard fashion. This protocol was adapted from the articles titled. Shoulder replacement surgery was first performed in the united states in the 1950s to treat severe shoulder fractures. This is because the articular surface of the round. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. North bristol shoulder service post operative rehabilitation guidelines produced by north bristol nhs trust. Improvement continues for 18 months to 2 years and the patients should continue exercising until their maximum potential has been reached. Applications for the reading shoulder fellowship starting in late 2019 and for 2020 is now open. Reverse or inverse total shoulder arthroplasty rtsa is designed. In a reverse total shoulder replacement, the socket and metal ball are switched. Stability and mobility of the shoulder joint is now dependent.
Reverse total shoulder protocol precautions no shoulder motion behind lower back and hip x 12 weeks no internal rotation ir x 12 weeks no cross chest adduction x 12 weeks fe in scaption only caution in er with stretching, sudden movements no supporting of body weight with affected extremity for 12 weeks. This is because the articular surface of the round humeral head is approximately four times greater than. Reverse shoulder arthroplasty protocol with subscapularis release see last page for patients with special considerations related to surgical approach and procedure week one weeks two to three initial evaluation evaluate posture and position of the shoulder girdle inspect for signs of infection, and ensure integrity of the incision. When arthritis affects the shoulder it can cause the lining of these joint surfaces to. Reverse shoulder replacement delta3 shoulderdoc by prof.
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. Gentle closed kinetic chain shoulder and scapular stabilization drills wall ball. Reverse total shoulder arthroplasty protocol 1 boston shoulder. Before suggesting the operation, your doctor will have considered that the benefits of having the operation outweigh any disadvantages. George utah narrates a video demonstration of a reverse total shoulder arthroplasty shoulder replacement. Shoulder replacement surgery relieves pain and helps restore motion, strength and function of the shoulder. It is often the preferred method when there has been advanced damage to the rotator cuff as seen in rotator cuff arthropathy.
Customized for surgeon preferences, exactechgps is a powerful addition to the surgical teams goals of achieving efficacy, efficiency and economics for shoulder arthroplasty. An artificial socket is attached to the top of the arm bone. Management of complications after reverse shoulder. Shoulder arthroplasty and reverse ball and socket arthroplasty. Each case can be very different depending on the goals of the patient, the age of the. The most common indications are rotator cuff tear arthropathy. Your shoulder is a ball and sockettype joint made up of two main parts. Reverse or inverse total shoulder arthroplasty rtsa is designed specifically for the. Rehabilitation guidelines for reverse total shoulder. This new prosthesis reverses the normal ballandsocket relationship of the shoulder joint. Total shoulder replacement protocol sports and ortho.
The head of the upper arm bone humerus is the ball and a circular depression glenoid in the shoulder bone scapula is the socket. Reverse shoulder replacement uw orthopaedics and sports. The rehabilitation protocol for total shoulder arthroplasty tsa hemiarthroplasty hhr is based on the latest research. Specific interventions should be based on the needs of the individual and. The exactechgps shoulder application was developed in conjunction with. 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. Reverse total shoulder arthroplasty rtsa has become the treatment of choice for patients with rotator cuff arthropathy. Request pdf inversereverse polarity arthroplasty for cuff tears with arthritis including cuff tear arthropathy the first total shoulder replacement is widely credited to dr. Rehabilitation following reverse total shoulder arthroplasty jospt. Reverse total shoulder replacement is indicated for use in grossly rotator cuff deficient joints. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. Hemiarthroplasty and total shoulder replacement have been tried but reported to have poor outcome. The intent of this protocol is to provide the clinician with a guideline to establish and progress a patient through post operative rehabilitation.
Sep 12, 2012 randy clark, md from coral desert orthopedics in st. Jan 01, 2007 the reverse shoulder prosthesis was approved for clinical use in the united states in march 2004. 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. The large deltoid muscle that covers the shoulder is typically able to move the arm. An artificial ball is attached to the shoulder blade. If the risks associated with the procedure are determined to be acceptable for the patients expected benefit, the follow technique for reverse total shoulder arthroplasty can be used. Reverse total shoulder replacement sports and ortho. Please click the document and find more more information about this. 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.
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. Rehabilitation following total shoulder arthroplasty reg b. Protoco reverse polarity shoulder arthroplasty introduction the reverse shoulder replacement changes the orientation of the shoulder, changing the mechanics of the shoulder. Rehabilitation following total shoulder arthroplasty. Reverse shoulder replacement in the younger population. Reverse shoulder replacement delta3 shoulderdoc by. There is an acceptance that reverse shoulder replacement should be performed cautiously in the younger population8,9,19. Rehabilitation protocol for reverse shoulder arthroplasty. The reverse shoulder replacement is designed for patients who dont have a functioning rotator cuff, or normal shoulder anatomy. Aequalis reversed ii shoulder system wright medical group.
It is a complex procedure associated with significant risks. It is not intended to be a substitute for ones clinical decision making. 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. Radiologic assessment of reverse shoulder arthroplasty. Inversereverse polarity arthroplasty for cuff tears with. 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. Distalization of the humerus, resulting in retensioning of the deltoid muscle and any rotator cuff muscles that are still. Reverse polarity shoulder has evolved since last two decades and its outcome is promising in this pathology.
Total shoulder arthroplastyhemiarthroplasty protocol. The reasons for reverse shoulder replacement surgery. Reverse total shoulder protocol precautions no shoulder motion behind lower back and hip x 12 weeks no internal rotation ir x 12 weeks no cross chest adduction x 12 weeks fe in scaption only caution in er with stretching, sudden movements no supporting of. The sling is worn for comfort for approximately 34 weeks. 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 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 grossly rotator cuff deficient joint. 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. The reverse shoulder replacement has the ball of the shoulder joint where the socket should be and the socket where the ball usually is in normal anatomy.
Randy clark, md from coral desert orthopedics in st. This is due to the relatively new concept of the modern reverse prosthesis therefore there is at present limited amount of long term outcome on this technology. May 27, 2015 reverse shoulder replacement surgery and rehabilitation. Jan 26, 2018 in a reverse shoulder replacement, the normal ballandsocket structure is reversed. North bristol nhs trust shoulder service post operative. A conventional shoulder replacement device mimics the normal anatomy of the shoulder. In a reverse shoulder replacement the structure of your shoulder. Total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. The start of this protocol will often be delayed 34 weeks following rtsa for a revision. Reverse shoulder replacement surgery and rehabilitation. Rehabilitation protocol for reverse shoulder arthroplasty this protocol is intended to guide clinicians and patients through the postoperative course after a reverse shoulder arthroplasty.
A reverse total shoulder arthroplasty rtsa also known as a reverse total shoulder replacement rtsr is a variant on the standard total shoulder replacement tsr. Reverse total shoulder replacement is a complex procedure and is warranted by certain conditions. However, if the tendons are severely damaged, an operation called reverse shoulder replacement may be a better way to improve the joints function and reduce pain, especially if the joint is affected by arthritis. Reverse total shoulder replacement phase i weeks 06 sling immobilization for first 6 weeksout of sling to do home exercise program pendulums twice daily therapeutic exercise o grip strengthening o elbowwristhand exercises o teach home exercises pendulums heatice before and after pt sessions. Reverse shoulder replacement is commonly performed and is generally a safe procedure. Complication rate after rtsa has been reported to be three to five times that of conventional total shoulder arthroplasty. Jul 18, 2014 reverse shoulder replacement in the younger population. Reverse total shoulder replacement sunnybrook hospital. Reverse polarity total shoulder replacement introduction. Rehabilitation protocol for total shoulder arthroplasty. Reverse polarity shoulder replacement information about reverse polarity shoulder replacement can be found in this pdf. Information leaflets shoulder surgery, arthroscopy uk.
Over the years, shoulder joint replacement has come to be used for many other painful conditions of the shoulder, such as different forms of arthritis. Specific changes in the program will be made by the physician as appropriate for an individual patient. Reverse total shoulder replacement rehabilitation guidelines. Department of rehabilitation services reverse total. 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.
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