Anatomical and biomechanical framework for shoulder arthroplasty rehabilitation

Wolff, Aviva L.; Rosenzweig, Lee

doi:10.1016/j.jht.2017.05.009

Cited by 24 publications

(33 citation statements)

References 61 publications

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“…1−3 Total shoulder arthroplasty (TSA) surgeries have increased by approximately 3000 cases every year for the past 12 years in the US. 4 This increase in occurrence has led to changes in both implant design and surgical techniques 5 as well as increased referral for postoperative rehabilitation. There is a large body of evidence describing surgical technique and implant design; however, specific postoperative rehabilitation contribution is lacking.…”

Section: Introductionmentioning

confidence: 99%

“…There is a large body of evidence describing surgical technique and implant design; however, specific postoperative rehabilitation contribution is lacking. 5 Many rehabilitation studies are based on the original protocol developed by Neer and Hughes in 1975, with progression based on timelines rather than subjective or objective data. A systematic review by Kraus et al revealed that most rehabilitation protocols were broken into 3 or 4 phase models but differed greatly on when to initiate treatment, allowable range of motion (ROM) and when to initiate strengthening.…”

Section: Introductionmentioning

confidence: 99%

“…Other pathologies indicating TSA include rheumatoid arthritis, avascular necrosis and traumatic fracture. 5 Often the patient undergoing TSA is over 65 years of age with chronic shoulder pathology 6 or symptoms that have not significantly decreased with conservative treatment. These patients have often had dysfunction and pain for years prior to undergoing TSA and have resultant weakness and postural imbalance.…”

Section: Introductionmentioning

confidence: 99%

“…TSA involves a surgical approach through the deltoid and pectoralis major to expose the glenohumoral joint. The biceps, coracobrachialis and pectoralis minor are retracted, the coracoacromial ligament is released as is the subscapularis, 5 pectoralis major and lattisimus dorsi. 6 Metal implants replace the surface of the humeral head and the glenoid fossa.…”

Section: Introductionmentioning

confidence: 99%

“…Protection of the healing subscapularis tendon is crucial during rehabilitation. 5,6 Much of the published literature involving TSA focuses on preoperative tissue status, implant design and surgical technique, rather than post-operative rehabilitation protocol. It is clear that post-operative rehabilitation is pivotal in determining successful outcome following TSA.…”

Section: Introductionmentioning

confidence: 99%

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Physical therapy rehabilitation following total shoulder replacement using total motion release techniques in combination with traditional intervention

Walker¹

2018

MOJSM

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Aim: The incidence of shoulder replacement surgery has increased significantly in the past 10 years, becoming the 3rd most performed total joint arthroplasty after hip and knee and is expected to continue to rise with the increase in the active senior population of the United States. This case study describes rehabilitation following total shoulder arthroplasty (TSA) using a combination of traditional intervention and Total Motion Release (TMR) techniques. TMR is an intervention technique based on the concept of contralateral movement to affect fascial glide and neuromuscular dysfuntion. Case description: The patient was a 71-year old female who underwent a total shoulder replacement for treatment of significant osteoarthritis. Initially she presented with significant pain, loss of strength, range of motion (ROM) and function. Intervention: Traditional therapeutic exercise and manual therapy was combined with TMR techniques, including contralateral arm raise, straight leg raise and spine twist, to control pain and allow the patient earlier achievement of shoulder ROM. Outcome: Subjective report included decreased pain and improved function assessed with the QuickDASH, as well as satisfaction with the rapidity of recovery. Improved passive range of motion (PROM), active range of motion (AROM), posture and strength was also recorded at discharge. Discussion: A combination of traditional intervention and TMR techniques were successful in controlling pain early in rehabilitation, as well as restoring function and ROM. This case study supports the use of TMR during TSA rehabilitation.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%