Total Shoulder Arthroplasty and Rehabilitation

Abstract

Total shoulder arthroplasty is the recommended surgical procedure for glenohumeral arthritis once conservative management is exhausted. Meticulous surgical technique and skilled, carefully supervised, progressive rehabilitation is essential to ensure that the range of motion can be maximized, whereas improved strength, functional goals, and pain relief are achieved. It is critical that the rehabilitation program is evaluation based, that any soft tissue repairs performed intraoperatively are protected while healing takes place, and soft tissue stretching is minimized within the first 6 weeks after surgery. The preoperative diagnosis, range of motion, and function frequently correlate with postoperative success and patient satisfaction. Patient compliance is critical to ensure optimal recovery. Rehabilitation after total shoulder arthroplasty may be modified if concomitant soft tissue procedures, such as a rotator cuff repair or subscapularis lengthening is performed, as the protection and optimization of soft tissue rehabilitation correlates highly with the outcome. It is critical for the health care team to communicate important and relevant specifics of the surgical procedure to ensure proper progression, and that, in efforts to efficiently provide guided rehabilitation, the specific exercises are not advanced too rapidly. Copyright © 2014 by Lippincott Williams & Wilkins.