Physical Therapy Protocols for Arthroscopic Bankart Repair

DeFroda, Steven F.; Mehta, Nabil; Owens, Brett D.

doi:10.1177/1941738117750553

Cited by 35 publications

(41 citation statements)

References 11 publications

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“…All rehabilitation protocols were reviewed for components of immobilization and rehabilitation. To effectively compare rehabilitation protocols, categories previously published by DeFroda et al 5 were utilized. These included postoperative adjunct therapy, early range of motion (ROM), passive ROM start dates and goals, late ROM exercises and goals, resistance exercises and strengthening, and sport-specific activities.…”

Section: Methodsmentioning

confidence: 99%

“…6,9 Regardless of the technique or strategy used to treat anterior shoulder instability, the role of postoperative rehabilitation is critical in achieving functional stability and appropriate return to activity. 4,5,8 Nonetheless, there is a paucity of high-quality evidence investigating the effect of rehabilitation programs on functional outcomes after both arthroscopic and open stabilization procedures. Furthermore, while The American Society of Shoulder and Elbow Therapists has published a consensus rehabilitation guideline for anterior arthroscopic capsulolabral repair of the shoulder, no similar guidelines have been produced for open stabilization procedures such as the Latarjet.…”

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confidence: 99%

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A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair

Beletsky

Cancienne²,

Manderle

et al. 2020

Sports Health: A Multidisciplinary Approach

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Context: Recent studies examining return to sport after traumatic shoulder instability suggest faster return-to-sport time lines after bony stabilization when compared with soft tissue stabilization. The purpose of the current study was to define variability across online Latarjet rehabilitation protocols and to compare Latarjet with Bankart repair rehabilitation time lines. Evidence Acquisition: Online searches were utilized to identify publicly available rehabilitation protocols from Accreditation Council for Graduate Medical Education (ACGME)–accredited academic orthopaedic surgery programs. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Results: Of the 183 ACGME-accredited orthopaedic programs reviewed, 14 institutions (7.65%) had publicly available rehabilitation protocols. A web-based search yielded 17 additional protocols from private sports medicine practices. Of the 31 protocols included, 31 (100%) recommended postoperative sling use and 26 (84%) recommended elbow, wrist, and hand range of motion exercises. Full passive forward flexion goals averaged 3.22 ± 2.38 weeks postoperatively, active range of motion began on average at 5.22 ± 1.28 weeks, and normal scapulothoracic motion by 9.26 ± 4.8 weeks postoperatively. Twenty (65%) protocols provided specific recommendations for return to nonoverhead sport–specific activities, beginning at an average of 17 ± 2.8 weeks postoperatively. This was compared with overhead sports or throwing activities, for which 18 (58%) of protocols recommended beginning at a similar average of 17.1 ± 3.3 weeks. Conclusion: Similar to Bankart repair protocols, Latarjet rehabilitation protocols contain a high degree of variability with regard to exercises and motion goal recommendations. However, many milestones and start dates occur earlier in Latarjet protocols when compared with Bankart-specific protocols. Consequently, variability in the timing of rehabilitation goals may contribute to earlier return to play metrics identified in the broader literature for the Latarjet procedure when compared with arthroscopic Bankart repair. Strength of Recommendation Taxonomy (SORT): Level C.

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Section: Methodsmentioning

confidence: 99%

mentioning

confidence: 99%

A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair

Beletsky

Cancienne²,

Manderle

et al. 2020

Sports Health: A Multidisciplinary Approach

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“…Beginn der Mobilisation der Schulteraußenrotation ab der 4. Woche nach einer Bankart-Operation, Joggen nach einer Rekonstruktion des vorderen Kreuzbandes nach 3 Monaten) [11] [54]. Ein solcher Ansatz kann durchaus begründet sein.…”

Section: Hintergrundunclassified

“…Ein zeitbasiertes Schema hat insbesondere dann eine Bedeutung, wenn es sich an einer verringerten Belastung traumatisierter Strukturen im Rahmen der Wundheilung orientiert. Leider zeigen Übersichtsarbeiten aber, dass bei gleicher Operationsmethode völlig unterschied-licheVorgabenbestehen[6] [11] [53] [54].Offensichtlich stehen daher weniger physiologische Prinzipien, sondern eher persönliche Präferenzen von Ärzten und Therapeuten im Vordergrund.…”

Section: Hintergrundunclassified

Progressionen in der muskuloskelettalen Rehabilitation

Diemer¹

2020

Sportphysio

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“…Early rehabilitation after shoulder stabilization surgery focuses on pain control, protection of the surgical repair, prevention of a "stiff" shoulder, and regaining scapular control [13][14][15]. Within six weeks post-operative, the patient should achieve a minimum of 90 degrees of shoulder elevation and 10-20 degrees of external rotation at 50 degrees of scaption [13][14][15]. Elevated levels of pain may contribute to an inability to regain range of motion during early rehabilitation after shoulder stabilization surgery.…”

Section: Introductionmentioning

confidence: 99%

The Effectiveness of Battlefield Acupuncture in Addition to Standard Physical Therapy Treatment after Shoulder Surgery: A Protocol for a Randomized Clinical Trial

Crowell

Brindle

Mason

et al. 2020

Preprint

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Introduction: There is a large incidence of shoulder instability among active young athletes and military personnel. Shoulder stabilization surgery is the commonly employed intervention for treating individuals with instability. Following surgery, a substantial proportion of individuals experience acute post-operative pain, which is usually managed with opioid pain medications. Unfortunately, the extended use of opioid medications can have adverse effects that impair function and reduce military operational readiness, but there are currently few alternatives. However, Battlefield Acupuncture (BFA) is a minimally invasive therapy demonstrating promise as a non-pharmaceutical intervention for managing acute post-operative pain.Methods: This is a parallel, two-arm, single-blind randomized clinical trial. The two independent variables are intervention (2 levels; standard physical therapy and standard physical therapy plus Battlefield Acupuncture) and time (5 levels; 24-hours, 48-hours, 72-hours, 1-week, and 4-weeks post shoulder stabilization surgery). The primary dependent variables is worst and average pain as measured on the Visual Analog Scale. Secondary outcomes include medication usage, Profile of Mood States, and Global Rating of Change.Discussion: The magnitude of the effect of BFA is uncertain; current studies report confidence intervals of between group differences that include minimal clinically important differences between intervention and control groups. The results of this study may help determine if BFA is an effective adjunct to physical therapy in reducing pain and opioid usage in acute pain conditions. Trial registration: ClinicalTrials.gov, NCT04094246. Registered 16 September 2019, http://clinicaltrials.gov/NCT04094246.

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Physical Therapy Protocols for Arthroscopic Bankart Repair

Abstract: This study highlights the importance of attending surgeons being very clear and specific with regard to their physical therapy instructions to patients and therapists.

Cited by 35 publications

References 11 publications

A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair

A Comparison of Physical Therapy Protocols Between Open Latarjet Coracoid Transfer and Arthroscopic Bankart Repair

Progressionen in der muskuloskelettalen Rehabilitation

The Effectiveness of Battlefield Acupuncture in Addition to Standard Physical Therapy Treatment after Shoulder Surgery: A Protocol for a Randomized Clinical Trial

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