Abstract:
INTRODUCTION:Postoperative rehabilitation is considered essential and indeed routine practice following rTSA. However, the optimal approach to postoperative rehabilitation is unknown, based on protocols for anatomic TSA, published literature is sparse, as is the quantity and quality of research evidence. OBJECTIVE:To outline the accelerated rehabilitation protocol (with immediate activity and no immobilization at all) following reverse total shoulder arthroplasty (rTSA) and assess its safety and effectiveness compared to the more conservative rehabilitation protocols of immobilization in a sling for 6 weeks and 3 weeks. MATERIAL AND METHODS:Between July 2005 and October 2017, 357 consecutive rTSA in 320 patients underwent a primary rTSA and were included in the study. Patients were divided into 3 groups depending on rehabilitation protocol (6 weeks or 3 weeks postoperative immobilization respectively for group 1, 2 and no-immobilization for group 3). Patients were assessed preoperatively and reviewed at 3 weeks, 3, 6, 12 months and yearly thereafter postoperatively. Constant Score (CS), Subjective Shoulder Value (SSV), patient satisfaction and pain scores were used at each appointment and patients assessed both clinically and radiographically. RESULTS:Mean age at surgery was 76 years (range 40 - 93). At 1-year follow-up, Constant Score (CS) improved from 16.6 (adjusted 23.9) to 63.2 (adjusted 91.5) in group 1 (n=114), from 21.5 (adjusted 30.7) to 67.7 (adjusted 98.4) in group 2 (n=125) and from 22.6 (adjusted 31.3) to 66.6 (adjusted 94.9) in group 3 (n=118). Pain score improved from 3.1/15 preoperatively to 12.5/15 postoperatively in group 1, from 3.5/15 to 13/15 in group 2 and from 3.7/15 to 12.5/15 in group 3. SSV improved to 8.5/10, 8.6/10 and 8.1/10 for groups 1, 2 and 3 respectively. Mean range of movement (ROM) improved to 142° elevation and 131° abduction in group 1, 153° elevation and 144° abduction in group 2 and 149° elevation and 146° abduction in group 3. No statistically significance differences were observed in CS, SSV, patient satisfaction, pain and ROM between the three groups. Less postoperative complications were observed in group 3 (No immobilization). CONCLUSION:Accelerated rehabilitation regime post rTSA without immobilization is safe and lead to reliable good clinical results and quick return to function. This study confirms non-inferiority of the accelerated rehabilitation regime with less postoperative complications related to falls. Accelerated rehabilitation regime post rTSA have further psychological and emotional advantage to the patient, with earlier return to normal function and regaining independence. We recommend the accelerated rehabilitation regime without immobilization following rTSA.
journal_name
J Shoulder Elbow Surgjournal_title
Journal of shoulder and elbow surgeryauthors
Lee J,Consigliere P,Fawzy E,Mariani L,Witney-Lagen C,Natera L,Buch B,Atoun E,Sforza G,Amar E,Levy Odoi
10.1016/j.jse.2020.11.017subject
Has Abstractpub_date
2021-01-05 00:00:00eissn
1058-2746issn
1532-6500pii
S1058-2746(20)30963-0pub_type
杂志文章abstract::The concept of bipolar hemiarthroplasty has been described in the hip for more than 20 years, its role being to decrease acetabular wear. Shoulder bipolar hemiarthroplasty was described shortly afterward. The purpose of this study was to determine if the prosthesis acted as a bipolar device moving primarily at the inn...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2005.10.002
更新日期:2006-07-01 00:00:00
abstract::An anterior glenoid labrum reconstruction in conjunction with a modified anterior-inferior capsular shift is described and was performed in 64 patients (69 shoulders) with traumatic anterior or anterior-inferior glenohumeral instability. Sixty-three operations were performed for recurrent dislocation and six for recur...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/1058-2746(93)90076-S
更新日期:1993-11-01 00:00:00
abstract:BACKGROUND:Economic evaluations provide decision makers with a tool for reducing health care costs because they assess both the costs and consequences of health care interventions. This study reviewed the quality of published economic evaluations for shoulder pathologies. MATERIALS AND METHOD:A MEDLINE search was cond...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2011.05.019
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Obesity is linked to major health conditions and poor surgical outcomes. The impact of obesity on self-perceived outcome after rotator cuff repair (RCR) is unclear. MATERIALS AND METHODS:We studied 154 patients who underwent RCR. Obesity was considered a body mass index (BMI) greater than 30. Preoperative a...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2010.03.003
更新日期:2010-12-01 00:00:00
abstract:BACKGROUND:Arthroscopic excision of an osteoid osteoma was first reported in the knee joint; since then, there have been several reports of arthroscopic excisions in the knee, shoulder, and elbow, with inconclusive outcomes because of a limited number of cases. The aim of this prospective study was to evaluate the medi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.01.010
更新日期:2017-05-01 00:00:00
abstract:BACKGROUND:To examine the rates and predictors of deep periprosthetic infections after primary total shoulder arthroplasty (TSA). METHODS:We used prospectively collected data on all primary TSA patients from 1976-2008 at Mayo Clinic Medical Center. We estimated survival free of deep periprosthetic infections after pri...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2012.01.006
更新日期:2012-11-01 00:00:00
abstract::We report 31 patients with displaced fractures of the proximal humerus treated by transitory percutaneous pinning. The Neer fracture classification was used; there were 7 two-part, 20 three-part, and 4 four-part fractures. The Constant score was used for evaluation of the results; the mean score was 80 points. The hig...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/s1058-2746(99)90091-5
更新日期:1999-11-01 00:00:00
abstract:HYPOTHESIS AND BACKGROUND:The role of degeneration is not well understood for rotator cuff pain. If age-related degenerative changes would be the cause of symptoms, degeneration would precede or concur with self-reported pain. We performed 3 systematic literature reviews. Our objectives were to determine the prevalence...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.09.060
更新日期:2017-05-01 00:00:00
abstract::Rotator cuff tears represent the most common shoulder injuries in the United States. The debilitating effect of this degenerative condition coupled with the high incidence of failure associated with existing graft choices underscores the clinical need for alternative grafting solutions. The 2 critical design criteria ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2011.11.016
更新日期:2012-02-01 00:00:00
abstract::Glenoid component loosening is the most common early mode of failure of total shoulder arthroplasty (TSA) We hypothesised that the use of a pegged glenoid component with a modern glenoid reaming system and an instrumented cement pressurization technique would achieve a low prevalence of early radiolucent lines. Of 81 ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jse.2008.01.147
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:Significantly displaced juvenile proximal humeral fractures (Neer-Horowitz type 3 and 4) usually require reduction and fixation. The most commonly used fixation methods are Kirschner wire (K-wire) pinning or retrograde elastic stable intramedullary nailing (ESIN). However, results comparing the long-term out...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.01.015
更新日期:2014-10-01 00:00:00
abstract:BACKGROUND:The purpose of this study was to perform a cross-sectional analysis of diversity among academic shoulder and elbow surgeons in the United States. METHODS:US shoulder and elbow surgeons who participated in shoulder and elbow fellowship and/or orthopedic surgery resident education as of November 2018 were inc...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.11.035
更新日期:2020-04-01 00:00:00
abstract::Protection of the anterior aspect of the deltoid muscle is critical to the success of shoulder arthroplasty. Between 1975 and 1980, 75 patients with 81 shoulder arthroplasties had exposure via the anteromedial approach with careful anterior deltoid detachment through fascial tissues, systematic repair, and standardize...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2004.02.009
更新日期:2004-09-01 00:00:00
abstract:HYPOTHESIS:Type IIA, IIB, and V lateral clavicular fractures (Craig modification of the Neer classification) are characterized by a constant displacement and are associated with a high rate of nonunion. The aim of this study is to verify whether the reduction and arthroscopic stabilization of these clavicular fractures...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.05.016
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:Mobile technology offers the prospect of delivering high-value care with increased patient access and reduced costs. Advances in mobile health (mHealth) and telemedicine have been inhibited by the lack of interconnectivity between devices and software and inability to process consumer sensor data. The object...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.01.013
更新日期:2018-07-01 00:00:00
abstract:BACKGROUND:The purposes of this study were to establish thresholds for improvement in patient-reported outcome scores that signify the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptomatic state (PASS) after biceps tenodesis (BT) and to assess patient var...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.09.025
更新日期:2019-04-01 00:00:00
abstract:BACKGROUND:Although many advantages of reverse total shoulder arthroplasty (RTSA) have been demonstrated, a variety of complications indicate there is much to learn about how RTSA modifies normal shoulder function. This study used a subject-specific computational model driven by in vivo kinematic data to assess how RTS...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.015
更新日期:2016-04-01 00:00:00
abstract::Nonunion of the proximal humerus is a challenging problem. Since 1996, we have performed interlocking intramedullary nailing for the treatment of proximal humeral nonunions with the Straight Nail System and bone grafting. The objective of this study was to investigate the clinical outcomes of this procedure in patient...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2008.02.006
更新日期:2008-09-01 00:00:00
abstract:BACKGROUND:The purpose of this study was (1) to evaluate the rates of reverse shoulder arthroplasty (RSA) revisions during a 12-year period, (2) to assess the influence of primary diagnosis and the impact of implant modifications on revisions, (3) to describe surgical management of failed RSA, and (4) to analyze outcom...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2015.09.027
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND AND HYPOTHESIS:IDEAL (Iterative Decomposition of Echoes of Asymmetrical Length) imaging is a magnetic resonance imaging sequence that precisely measures rotator cuff muscle fatty infiltration. The influence of lower levels of fatty infiltration on outcomes after rotator cuff repair remains unclear. We hypoth...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.05.018
更新日期:2019-10-01 00:00:00
abstract:BACKGROUND:There is an increasing trend toward the use of reverse total shoulder arthroplasty (RTSA) over stemmed hemiarthroplasty (HA) for the management of proximal humeral fractures. There are limited data available comparing the revision rates for RTSA and HA in the setting of a fracture. The aim of this study was ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2020.04.005
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Loosening associated with cemented polyethylene glenoid components is a major concern following total shoulder arthroplasty (TSA). The purpose of this study was to investigate the clinical and radiographic results associated with use of a novel uncemented soft-metal-backed glenoid component (SMBG), with a mi...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,评审
doi:10.1016/j.jse.2009.12.021
更新日期:2010-06-01 00:00:00
abstract:BACKGROUND:Multiple perioperative factors have been implicated in infection risk after shoulder arthroplasty. The purpose of this study was to determine surgical site infection (SSI) risk due to medical comorbidities or blood transfusion after primary or revision shoulder arthroplasty. METHODS:Comprehensive data on me...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.04.006
更新日期:2017-11-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to compare the acromiohumeral distance (AHD) between patients diagnosed with hypermobility type of the Ehlers-Danlos syndrome (hEDS) or hypermobility spectrum disorder (HSD) and healthy controls by evaluating the relative amount the tendon occupies in the subacromial area. Furth...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2019.08.003
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND:A novel arthroscopic technique allows for intraosseous tendon placement in biceps tenodesis using bone tunnels and suture while avoiding the expense of an implant. No biomechanical characterization exists for this construct. METHODS:Tensile tests were used to compare a suture-only biceps tenodesis technique...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2014.02.027
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to eval...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2013.11.020
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:Previous meta-analyses comparing the surgical and nonsurgical treatment of midshaft clavicle fractures have demonstrated extensive heterogeneity, that is, treatment effect variation, in different pooled outcomes. We aimed to investigate the amount of heterogeneity seen in pooled treatment effects and to expl...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章,meta分析
doi:10.1016/j.jse.2020.02.011
更新日期:2020-08-01 00:00:00
abstract:BACKGROUND:This study evaluated patients with and without a prosthetic dislocation after reverse total shoulder arthroplasty (RTSA) to identify risk factors for instability. METHODS:Dislocation and nondislocation cohorts were established for analysis in 119 patients who had undergone RTSA at our institution between 20...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2018.04.015
更新日期:2018-11-01 00:00:00
abstract:BACKGROUND:Higher critical shoulder angle (CSA) is correlated with rotator cuff tears (RCTs), whereas lower CSA is associated with glenohumeral osteoarthritis (OA). Our goal was to investigate whether patients with concurrent glenohumeral OA and full-thickness RCTs demonstrate a higher CSA than patients with OA alone. ...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2017.05.020
更新日期:2017-12-01 00:00:00
abstract:BACKGROUND:Magnetic resonance imaging (MRI) arthrography has been considered the gold standard for imaging ulnar collateral ligament (UCL) injuries. No classification system has been described for UCL tears to help discuss and guide treatment options. We propose that an MRI-based UCL classification system would correla...
journal_title:Journal of shoulder and elbow surgery
pub_type: 杂志文章
doi:10.1016/j.jse.2016.05.006
更新日期:2016-10-01 00:00:00