The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation for anatomic total shoulder arthroplasty.

J Shoulder Elbow Surg · Oct 2020 · Review

Kennedy JS, Garrigues GE, Pozzi F, Zens MJ, Gaunt B, Phillips B, et al.

Human Performance Rehabilitation Centers at St Francis Rehabilitation Center, Columbus, GA

Shoulder & Elbow Sports Medicine

SUMMARY — THE REDUCTIONThis expert consensus statement outlines a three-stage, evidence-based rehabilitation protocol for anatomic total shoulder arthroplasty and hemiarthroplasty to guide postoperative care alongside surgeon and patient factors.
Abstract, as published

Anatomic total shoulder arthroplasty is the gold standard shoulder replacement procedure for patients with an intact rotator cuff and sufficient glenoid bone to accommodate prosthetic glenoid implant and offers reliable patient satisfaction, excellent implant longevity, and a low incidence of complications. Disparity exists in the literature regarding rehabilitation strategies following anatomic total shoulder arthroplasty. This article presents a consensus statement from experts in the field on rehabilitation following anatomic total shoulder arthroplasty. The goal of this consensus statement is to provide a current evidence-based foundation to inform the rehabilitation process after anatomic total shoulder arthroplasty. These guidelines apply to anatomic total shoulder arthroplasty (replacement of the humeral head and glenoid), hemiarthroplasty (replacing only the humeral head), and hemiarthroplasty with glenoid reaming or resurfacing. The consensus statement integrates an extensive literature review, as well as survey results of the practice patterns of members of the American Society of Shoulder and Elbow Therapists and the American Shoulder and Elbow Surgeons. Three stages of recovery are proposed, which initially protect and then gradually load soft tissue affected by the surgical procedure, such as the subscapularis, for optimal patient outcomes. The proposed guidelines should be used in collaboration with surgeon preferences and patient-specific factors.

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