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Physical therapy for reverse total shoulder arthroplasty

What is a reverse total shoulder arthroplasty?

Though thousands of conventional total shoulder replacements are performed each year on patients with shoulder arthritis and other shoulder conditions, patients with large rotator cuff tears or other complex shoulder conditions may see greater benefits from what’s known as a reverse total shoulder arthroplasty.

While a conventional shoulder replacement is intended to mimic the shoulder’s natural anatomy, a reverse total shoulder arthroplasty relies on the deltoid muscle instead of the rotator cuff to position and move the arm. It’s often the preferred surgery for patients with a rotator cuff that is considered to be beyond repair.

Source: OrthoInfo

When is reverse total shoulder arthroplasty necessary?

Most shoulder conditions and injuries can be addressed with a conventional total shoulder replacement, but some patients are stronger candidates for a reverse total shoulder arthroplasty. The procedure is typically recommended only in cases where the rotator cuff is torn beyond repair or has not responded to other treatments.

A cuff tear arthropathy, a complex fracture of the shoulder joint, a chronic shoulder dislocation, or a tumor in the shoulder joint may also call for a reverse total shoulder arthroplasty. Patients who’ve already undergone a previous shoulder replacement or other shoulder treatments such as cortisone injections may also be good candidates for the procedure.

The most common reasons for a reverse total shoulder arthroplasty include:

  • Torn rotator cuff
  • Cuff tear arthropathy
  • Chronic shoulder dislocation
  • Tumor in the shoulder joint

Source: OrthoInfo

What are the potential complications of a reverse total shoulder arthroplasty?

Generally speaking, complications are more likely to occur with a reverse total shoulder arthroplasty than with a total shoulder replacement. This is largely because the procedure is often used to correct very complex conditions, making the surgery difficult and somewhat high-risk.

The most common complications include lasting instability, infection, notching, loosening, nerve injury, spine fractures, intra-operative fractures, and component disengagements. That said, as technology and research continue to advance, such complications are becoming less common.

In addition, all patients can expect bleeding, stiffness, and soreness during and after their procedure. Doctors will typically prescribe medication to help with the recovery process, and a physical therapist can help improve mobility and reduce pain following surgery.

The most common complications of reverse total shoulder arthroplasty include:

  • Infection
  • Instability
  • Loosening
  • Pain

Source: NCBI

Physical therapy for reverse total shoulder arthroplasty

Physical therapy is vital for an effective recovery from reverse total shoulder arthroplasty, as the surgery essentially calls for a reversal of normal shoulder joint mechanics. Relearning how to use and move the shoulder is no easy task, but it’s made far easier with the help of a licensed physical therapist.

There are three key rehabilitation concepts that must be considered when creating a recovery plan for reverse total shoulder arthroplasty: joint protection, deltoid function, and establishing appropriate functioning expectations. To protect the joint, the patient should work with a physical therapist to develop strategies to avoid harm; seemingly simple activities such as tucking in a shirt can become dangerous following this procedure.

Enhancing the deltoid function requires a careful exercise routine that’s tailored to the patient’s condition and needs. Finally, it’s vital to establish functional expectations; as previously stated, simple activities can become dangerous after surgery, and patients need to be made aware of their limitations and learn to work within them.

Source: JOSPT

Luna — physical therapy at your home

Luna PTs specialize in treating patients recovering from reverse total shoulder arthroplasty. The surgery requires comprehensive care and rehabilitation, and patients cannot expect to make a full recovery without expert guidance. Luna offers physical therapy on demand, right when the patient needs it. The best part? Our patients can receive physical therapy right in the comfort of their own homes. That means no waiting lists, no waiting rooms, and no waiting in traffic — our therapists come to you.

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