Shoulder Common Surgeries Flashcards
what is a reconstruction
tissue that was not original tissue to fix site of injury
what are typical restrictions for ROM and strengthening for a reconstruction
less restrictive
done early during post-op rehab
repair
original tissue used in attempt to fix site of injury
what are typical restrictions for ROM and strengthening for a repair
more restrictive and slow progressing but still done early in rehab
arthroplasty
replacement of joint with prosthetic one
which protocol do you follow if a pt had 2 separate surgeries done at the same time
the slowest progressing protocol
arthroscopic
small incision made and scope surgical tools inserted through these portals for the surgery
open surgery
done if surgery can not be completed arthroscopically, larger incision so can see everything
for a rotator cuff repair what other ROM concerns outside of at the shoulder do you have with being in a sling so long
elbow and wrist
take off sling to straighten arm and bend wrist
why would PT be delayed with a rotator cuff repair
with larger tears to promote more healing
what does recovery look like for a rotator cuff tear
about 6 months but can take about a year
what factors will influence speed of recovery
size of tear
tissue quality
health of pt
total shoulder arthroplasty(TSA)
- 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
TSA is done when you have…
RA
osteoarthritis
traumatic fx of humeral head
avascular necrosis
with a TSA, what part of the joint capsule should you avoid stressing? which means while lying supine, what should the pt see?
- anterior
- should see elbow at all times to prevent dislocation
why are ROM restrictions common in early rehab for a TSA
avoid loosening of components or dislocation
reverse TSA
ball and socket switch sides
role of deltoid changes
what does the rTSA rely on the deltoid for
stability and mobility instead of rotator cuff
what pt would benefit from a rTSA
someone who would also benefit from a TSA but who also have irreparable RTC damage
what is there a higher risk for with rTSA than with TSA
shoulder dislocations
avoid what with a rTSA
shoulder ext past neutral and combo of shoulder add and IR for 10-12wks
what is the typical position for dislocation with rTSA
combo of IR, adduction and ext
- tucking in shirt, going to bathroom
during a labral repair how is the labrum reattached
to the glenoid fossa using screws with attached sutures
subacromial decompression
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
what are abduction pillows
- commonly seen in rotator cuff repairs, especially if they repaired the supraspinatus
- reduces tension on the repaired tendons of the supraspinatus
small abduction pillow
- abducts 13 degrees
- reduces tension on supraspinatus tendon anteriorly (27) and more posteriorly (56)
large abduction pillow
- abducts 25 degrees
- reduces tension on supraspinatus a little more anteriorly (42) than the small but more posterioly (56)
