Rehabilitation After Anatomic and Reverse Total Shoulder Arthroplasty: A Critical Analysis Review.

JBJS Rev · Feb 2020 · Review

Kirsch JM, Namdari S

Departments of Orthopaedic Surgery and Shoulder and Elbow Surgery, The Rothman Institute-Thomas Jefferson University,…

Shoulder & Elbow

SUMMARY — THE REDUCTIONThis critical review finds insufficient high-quality evidence to guide postoperative rehabilitation protocols after anatomic or reverse total shoulder arthroplasty, with no clear benefit of early motion or formal physical therapy.
Abstract, as published

Postoperative rehabilitation is believed to be essential in optimizing clinical outcome and function following shoulder arthroplasty. Despite this long-held notion, there is a paucity of high-quality evidence to guide rehabilitation protocols and practice. For patients undergoing anatomic total shoulder arthroplasty (ATSA), there are insufficient comparative data regarding type or duration of sling utilization. Based on current evidence, there is no appreciable benefit to early motion compared with a delayed-motion protocol following ATSA. There is insufficient literature to support the use of formal physical therapy over a physician-directed program following ATSA. At the present time, no high-quality evidence exists to guide the postoperative rehabilitation of patients undergoing reverse total shoulder arthroplasty (RTSA). Prospective randomized controlled trials evaluating postoperative management and rehabilitation following ATSA and RTSA are needed to guide best practices and optimize clinical outcomes.

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