Accelerated rehabilitation following reverse total shoulder arthroplasty

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine
• Biomedical Engineering

Background:

• Optimal postoperative rehabilitation protocols for reverse total shoulder arthroplasty (rTSA) remain unclear.
• Existing literature on rTSA rehabilitation is limited, with sparse research evidence.
• Current practices often adapt protocols from anatomic total shoulder arthroplasty (TSA).

Purpose of the Study:

• To outline an accelerated rehabilitation protocol for rTSA involving immediate activity and no immobilization.
• To assess the safety and effectiveness of this accelerated protocol.
• To compare accelerated rehabilitation with conservative protocols (3- and 6-week immobilization).

Main Methods:

• 357 primary rTSA procedures in 320 patients were analyzed.
• Patients were divided into three groups based on immobilization duration: 6 weeks, 3 weeks, or no immobilization.
• Clinical and radiographic assessments included Constant Score (CS), Subjective Shoulder Value (SSV), satisfaction, pain, and range of motion (ROM) at multiple follow-up intervals.

Main Results:

• All groups showed significant improvements in CS, SSV, pain scores, and ROM at 1-year follow-up.
• No statistically significant differences were found between groups for CS, SSV, satisfaction, pain, or ROM.
• The group with no immobilization experienced fewer postoperative complications.

Conclusions:

• An accelerated rehabilitation protocol without immobilization is safe and effective for rTSA.
• This approach leads to reliable clinical results and a quicker return to function.
• The accelerated protocol offers psychological benefits and promotes earlier independence with fewer complications.