A Systematic Review of Proposed Rehabilitation Guidelines Following Anatomic and Reverse Shoulder Arthroplasty

Bullock, Garrett S.; Garrigues, Grant E.; Ledbetter, Leila; Kennedy, June

doi:10.2519/jospt.2019.8616

Cited by 55 publications

(63 citation statements)

References 53 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

Section: Introductionmentioning

confidence: 99%

“…Total shoulder arthroplasty (TSA) procedures have doubled in the United States over the past ten years [1]. With approximately 70,000 surgeries each year, TSA has become the fastest growing total joint replacement procedure in the United States [1,2]. The number of procedures is expected to further increase given the aging population and the notable success of TSA procedures in restoring function and reducing pain [3,4].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Demographic and clinical factors associated with same-day discharge and unplanned readmission following shoulder arthroplasty: a retrospective cohort study

Burton

Finneran

Angerstein

et al. 2021

Korean J Anesthesiol

View full text Add to dashboard Cite

Background: We examined demographic and clinical factors associated with same-day discharge and unplanned readmission following shoulder arthroplasty in adult patients. Methods: Utilizing data from the American College of Surgeons National Surgical Quality Improvement Program database, we extracted all patients that underwent shoulder arthroplasty. The primary and secondary outcome of interest was same-day discharge and 30-day unplanned readmission, respectively. We utilized multivariable logistic regression to identify covariates associated with these two outcomes. The odds ratio (OR) and 95% confidence interval (CI) were reported for each covariate that remained in the final models. Results: There were 17,011 patients analyzed when identifying predictors for same-day discharge. There was an increase in same-day discharge from 2007 to 2016. The odds of same-day discharge were significantly better for males (P < 0.001). The odds of same-day discharge was significantly decreased for every 10-year increase in age and for patients with insulin dependent diabetes, poor functional status, chronic obstructive pulmonary disease, congestive heart failure, bleeding disorder, and comorbidity burden (all P < 0.001). There were 14,276 patients analyzed for hospital readmission. The odds of unplanned readmission were significantly higher for every 10-year increase in age and for patients with poor functional status, congestive heart failure, bleeding disorder, and higher comorbidity burden (all P < 0.001). Conclusions: The results of this study that preoperative comorbidities and advanced age reduce the odds of same-day discharge. Risk stratification, preoperative optimization, and coordinated care after surgery may be helpful to optimize patients for same-day discharge.

show abstract

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Demographic and clinical factors associated with same-day discharge and unplanned readmission following shoulder arthroplasty: a retrospective cohort study

Burton

Finneran

Angerstein

et al. 2021

Korean J Anesthesiol

View full text Add to dashboard Cite

show abstract

“…(1)(2)(3)(4) However, despite orthopaedic acceptance, significant disagreement exists regarding rTSA rehabilitation guidelines following surgery. (5)(6)(7)(8)(9)(10)(11)(12) Traditionally, postoperative rehabilitation has centered on staged physiotherapy followed by early protective and restrictive joint immobilization.…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

“…These principles were developed to avoid immediate post-surgical rehabilitation concerns like prosthesis instability/dislocation and acromial overload, stress reaction, and/or stress fracture commonly associated with deltoid over tension. (11,(13)(14)(15) Poorly understood complications that have been previously reported to occur at rates of 0-8%(16-18) and 2.8% (19) respectively.…”

Section: Introduction Background and Rationale {6a}mentioning

confidence: 99%

“…This is further illustrated by a recent commission on rehabilitation post rTSA by the German Society of Shoulder and Elbow Surgery (Deutsche Gesellschaft für Schulter-und Ellenbogenchirurgie e. V., DVSE) reporting they were unable to find a single guideline, systematic review, or level 1/2 study in their literature search dating back to1989. (61) Balanced against these dissenting views is the universal orthopaedists' acceptance therapy plays in optimizing patient outcomes, and the absolute need for high-quality prospective research (5,6,10,11,55).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Immediate Accelerated Shoulder Rehabilitation (IASR) vs. Standard Protocol following Reverse Total Shoulder Arthroplasty: A Randomized Controlled Trial.

DeVito

Hatch

Raja

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Recently, the reverse total shoulder arthroplasty (rTSA) became the most frequently performed form of shoulder replacement in the United States and abroad. While physical therapy is universally accepted and routinely practiced, published postoperative rehabilitation guidelines and modifications are based on protocols developed in 1975. Since then, the principle components and temporal concepts of timing and intensity of postoperative rehabilitation and protected immobilization have been controversially applied and expertly discussed without a prevailing consensus. Comparative literature that prospectively addresses treatment differences, influences on outcomes, and superiority or inferiority versus control does not exist. Thus, the objective of this pilot study is to compare an accelerated and immediate active shoulder rehabilitation (IASR) rehabilitation program with standard care in patients following rTSA. Methods:A prospective, randomized, controlled, parallel-designed, two-armed, non-blinded, superiority pilot trial. The comparator arms are an accelerated rehabilitation (IASR) strategy versus standardized care following rTSA (CPT: 23472). The primary outcome measures will be the change from pre-surgical baseline to 52 weeks post-surgery in the American Shoulder and Elbow (ASES) score, Simple Shoulder Test (SST), and global health assessment (PROMIS-10. Secondary and tertiary outcomes will assess subscapularis integrity, implant status, and overall rehabilitation costs compared to formal control. Patients will be recruited from a single site (TRIA Orthopaedic Center, Bloomington, MN) neighboring the fourteenth largest US metropolitan area.Discussion: This trial will be the first study to compare the efficacy and safety of two different postoperative rehabilitation strategies for patients following rTSA. Further, this will be the first study to investigate an accelerated rehabilitation program without a period of protected immobilization following rTSA. Finally, the results will assist in the shared clinical and surgical treatment decisionmaking process.

show abstract

Rehabilitation following shoulder arthroplasty in the United Kingdom National Health Service: A survey of publicly facing information

Littlewood

Morgan

Pitt

et al. 2020

Musculoskeletal Care

View full text Add to dashboard Cite

Introduction The prevalence of shoulder arthroplasty (SA) is rising, but there is limited research evaluating rehabilitation following SA and whether there is an optimal approach remains unknown. The aim of this study was to understand current National Health Service (NHS) practice for rehabilitation following SA as a platform for conducting much needed further research. Methods Two reviewers independently undertook electronic searches for publicly available information sheets (PIS) from websites of NHS Trusts that included detail about rehabilitation following SA, for example, duration of immobilisation. One reviewer extracted data, and a second reviewer verified this. Ethical approval Not required. Results Forty‐three PIS from 40 Trusts were identified. Twenty‐four referred to more than one type of arthroplasty (anatomic, reverse and hemiarthroplasty) but did not describe different approaches to rehabilitation based on prosthesis type. Twenty‐five PIS provided some instruction regarding movement restrictions, which varied considerably. All PIS referred to postoperative immobilisation, typically with a sling, with median duration of 4 weeks (range 0 to 8). Thirty‐four PIS reported commencing passive exercise immediately. Median time to commencing active exercise was 4 weeks (range 1 to 6) and 5 weeks (range 1 to 16) for resisted exercise. Median time expected to return to driving was 6 weeks (range 3 to 12) and general work 12 weeks (range 3 to 26). Conclusion This study has highlighted significant heterogeneity between rehabilitation approaches following SA, not previously reported in the United Kingdom, with a lack of specific rehabilitation PIS for different prosthesis types. Our results will facilitate evaluation of rehabilitation strategies in future research.

show abstract

A Systematic Review of Proposed Rehabilitation Guidelines Following Anatomic and Reverse Shoulder Arthroplasty

Cited by 55 publications

References 53 publications

Demographic and clinical factors associated with same-day discharge and unplanned readmission following shoulder arthroplasty: a retrospective cohort study

Demographic and clinical factors associated with same-day discharge and unplanned readmission following shoulder arthroplasty: a retrospective cohort study

Immediate Accelerated Shoulder Rehabilitation (IASR) vs. Standard Protocol following Reverse Total Shoulder Arthroplasty: A Randomized Controlled Trial.

Rehabilitation following shoulder arthroplasty in the United Kingdom National Health Service: A survey of publicly facing information

Contact Info

Product

Resources

About