Proposal for SICSeG guidelines for rehabilitation after anatomical shoulder prosthesis in concentric shoulder osteoarthritis

Fusaro, Isabella; Orsini, Stefania; Stignani, S.; Creta, Domenico; Cava, F. C.; Benedetti, Maria Grazia

doi:10.1007/s12306-013-0257-0

Cited by 12 publications

(2 citation statements)

References 19 publications

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“…These factors represent two independent prognostic elements, which can highly influence the patient’s recovery [ 5 ]. For this reason, a multidisciplinary approach, together with an effective communication and collaboration with surgeons represents optimal musculoskeletal care and has a fundamental importance in creating appropriate treatments [ 9 , 12 , 21 , 47 ] and to achieve the best possible results.…”

Section: Discussionmentioning

confidence: 99%

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Rehabilitation following shoulder arthroplasty: a survey of current clinical practice patterns of Italian physiotherapists

Brindisino,

Lorusso,

Usai

et al. 2023

Arch Physiother

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Background The incidence of Total Shoulder Arthroplasty (TSA) and Reverse Total Shoulder Arthroplasty (RTSA) is constantly increasing. As a result, the interest in post-surgical rehabilitation has grown, since it is crucial in order to achieve full recovery and successful outcomes. The first aim of this study is to investigate the Italian physiotherapists (PTs) clinical practice in the management of patients with TSA and RTSA and to compare it with the best evidence available in the literature. The second purpose of this study is to assess any existing difference between the survey answers and the different sample subgroups. Materials and methods This cross-sectional observation study was designed following the CHERRIES checklist and the STROBE guidelines. A 4-sections survey with a total of 30 questions was developed for investigating post-surgery rehabilitation management in patient with TSA and RTSA. The survey was sent to Italian PTs from December 2020 until February 2021. Results Six-hundred and seven PTs completed the survey regarding both TSA and RTSA; 43.5% of participants (n = 264/607) stated that TSA is more likely to dislocate during abduction and external rotation. Regarding reverse prosthesis, 53.5% (n = 325/607) affirmed RTSA is more likely to dislocate during internal rotation, adduction and extension. In order to recover passive Range of Motion (pROM), 62.1% (n = 377/607) of participants reported that they gain anterior flexion, abduction, internal rotation, external rotation up to 30°, with full pROM in all directions granted at 6–12 weeks. Regarding the active ROM (aROM), 44.2% (n = 268/607) of participants stated that they use active-assisted procedures within a range under 90° of elevation and abduction at 3–4 weeks and higher than 90° at 6–12 weeks, with full recovery at a 3-month mark. Sixty-five point seven percent of the sample (n = 399/607) declared that, during the rehabilitation of patients with TSA, they tend to focus on strengthening the scapular and rotator cuff muscles, deltoid, biceps and triceps. Conversely, 68.0% (n = 413/607) of participants stated that, for the rehabilitation of patients with RTSA, they preferably focus on strengthening the periscapular and deltoid muscles. Finally, 33.1% (n = 201/607) of participants indicated the instability of the glenoid prosthetic component as the most frequent complication in patients with TSA, while 42.5% (n = 258/607) of PTs identified scapular neck erosion as the most frequent post-RTSA surgery complication. Conclusions The clinical practice of Italian PTs effectively reflects the indications of the literature as far as the strengthening of the main muscle groups and the prevention of movements, which may result in a dislocation, are concerned. Some differences emerged in the clinical practice of Italian PTs, regarding the restoration of active and passive movement, the starting and progression of muscle strengthening and the return to sport (RTS). These differences are actually quite representative of the current knowledge in post-surgical rehabilitation for shoulder prosthesis in the rehabilitation field. Level of evidence V

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Section: Discussionmentioning

confidence: 99%

“…There are significant differences between current post-surgical rehabilitation programs, which are essentially based on experts’ opinion [ 5 , 8 , 9 , 12 , 20 , 21 ]. Notably, only few randomized controlled clinical trials concerning physiotherapy best practice are available [ 22 ].…”

Section: Introductionmentioning

confidence: 99%

Rehabilitation following shoulder arthroplasty: a survey of current clinical practice patterns of Italian physiotherapists

Brindisino,

Lorusso,

Usai

et al. 2023

Arch Physiother

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Shoulder Replacement

Kuhn

Dickinson

Desir³

2016

Shoulder Surgery Rehabilitation

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Soft tissue balancing in total shoulder replacement

Mueller

Hoy

2014

Curr Rev Musculoskelet Med

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Total shoulder arthroplasty is now capable of recreating near anatomic reproduction of native bony shoulder anatomy, but the function and longevity of anatomic shoulder replacement is dependent on a competent soft tissue envelope and adequate motoring of all musculo-tendinous units about the shoulder. Balancing the soft tissues requires understanding of the anatomy and pathology, as well as technical skills. The advent of reverse shoulder biomechanics has brought with it special requirements of understanding of the soft tissue elements still left in the shoulder despite major rotator cuff deficiency.

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Proposal for SICSeG guidelines for rehabilitation after anatomical shoulder prosthesis in concentric shoulder osteoarthritis

Cited by 12 publications

References 19 publications

Rehabilitation following shoulder arthroplasty: a survey of current clinical practice patterns of Italian physiotherapists

Rehabilitation following shoulder arthroplasty: a survey of current clinical practice patterns of Italian physiotherapists

Shoulder Replacement

Soft tissue balancing in total shoulder replacement

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