Shoulder Common Surgeries

Question 1

what is a reconstruction

Answer 1

tissue that was not original tissue to fix site of injury

Question 2

what are typical restrictions for ROM and strengthening for a reconstruction

Answer 2

less restrictive

done early during post-op rehab

Question 3

repair

Answer 3

original tissue used in attempt to fix site of injury

Question 4

what are typical restrictions for ROM and strengthening for a repair

Answer 4

more restrictive and slow progressing but still done early in rehab

Question 5

arthroplasty

Answer 5

replacement of joint with prosthetic one

Question 6

which protocol do you follow if a pt had 2 separate surgeries done at the same time

Answer 6

the slowest progressing protocol

Question 7

arthroscopic

Answer 7

small incision made and scope surgical tools inserted through these portals for the surgery

Question 8

open surgery

Answer 8

done if surgery can not be completed arthroscopically, larger incision so can see everything

Question 9

for a rotator cuff repair what other ROM concerns outside of at the shoulder do you have with being in a sling so long

Answer 9

elbow and wrist

take off sling to straighten arm and bend wrist

Question 10

why would PT be delayed with a rotator cuff repair

Answer 10

with larger tears to promote more healing

Question 11

what does recovery look like for a rotator cuff tear

Answer 11

about 6 months but can take about a year

Question 12

what factors will influence speed of recovery

Answer 12

size of tear
tissue quality
health of pt

Question 13

total shoulder arthroplasty(TSA)

Answer 13

• arthritic head of humerus is replaced by a smooth metal ball fixed to the humerus by a stem that fits within it
• arthritis glenoid fossa is resurfaced with a high-density polyethylene prosthesis

Question 14

TSA is done when you have…

Answer 14

RA
osteoarthritis
traumatic fx of humeral head
avascular necrosis

Question 15

with a TSA, what part of the joint capsule should you avoid stressing? which means while lying supine, what should the pt see?

Answer 15

• anterior

- should see elbow at all times to prevent dislocation

Question 16

why are ROM restrictions common in early rehab for a TSA

Answer 16

avoid loosening of components or dislocation

Question 17

reverse TSA

Answer 17

ball and socket switch sides

role of deltoid changes

Question 18

what does the rTSA rely on the deltoid for

Answer 18

stability and mobility instead of rotator cuff

Question 19

what pt would benefit from a rTSA

Answer 19

someone who would also benefit from a TSA but who also have irreparable RTC damage

Question 20

what is there a higher risk for with rTSA than with TSA

Answer 20

shoulder dislocations

Question 21

avoid what with a rTSA

Answer 21

shoulder ext past neutral and combo of shoulder add and IR for 10-12wks

Question 22

what is the typical position for dislocation with rTSA

Answer 22

combo of IR, adduction and ext

- tucking in shirt, going to bathroom

Question 23

during a labral repair how is the labrum reattached

Answer 23

to the glenoid fossa using screws with attached sutures

Question 24

subacromial decompression

Answer 24

arthroscopic debridement of end of acromion and any inflamed tissue such as rotator cuff tendons or subacromial bursa

may or may not include distal clavical excision

Question 25

what are abduction pillows

Answer 25

• commonly seen in rotator cuff repairs, especially if they repaired the supraspinatus
• reduces tension on the repaired tendons of the supraspinatus

Question 26

small abduction pillow

Answer 26

• abducts 13 degrees

- reduces tension on supraspinatus tendon anteriorly (27) and more posteriorly (56)

Question 27

large abduction pillow

Answer 27

• abducts 25 degrees

- reduces tension on supraspinatus a little more anteriorly (42) than the small but more posterioly (56)