Rehabilitation for Total Shoulder Arthroplasty with Reverse Prosthesis: protocol of the Physical and Rehabilitation Medicine Department of the Centro Hospitalar de Entre Douro e Vouga, E.P.E.

Abstract

otal shoulder arthroplasty with reverse prosthesis based on Grammont’s initial model of 1985 has been gaining increasing popularity. Initially designed as a solution for cuff-tear arthropathy, its current indications have been broadened to include advanced gleno-umeral pathology caused by rheumatic, traumatic or osteonecrotic processes. Rehabilitation following this kind of surgery has its own particularities, such as the design of the prosthetic components, the biomechanical changes of the shoulder joint, and the different surgical techniques. Due to the demanding needs of postoperative care for this type of arthroplasty, the Department of Physical Medicine and Rehabilitation of Centro Hospitalar de Entre Douro e Vouga (Santa Maria da Feira, Portugal) has elaborated a rehabilitation protocol for the patients that are submitted to this intervention. It involves a series of pre and postoperative functional evaluations and a rehabilitation program that is based on three general guiding principles: articular protection, promotion of deltoid function, and therapeutic individualization. This protocol also serves the goal of keeping an updated physiatric prescription through serial functional evaluation and of promotion of communication between the several elements of the multidisciplinary team that are involved in the rehabilitation process.

Keywords: Arthroplasty; Replacement; Shoulder Joint; Joint Prosthesis; Rehabilitation/standards; Prosthesis Design.