Cuff tear arthropathy - CTA - prosthesis for shoulder arthritis: Surgery with a cementless CTA prosthesis can lessen pain and improve function in shoulders with the combination of arthritis and rotator cuff tears.
Edited By: Winston J. Warme, MD, Frederick A. Matsen III, M.D.
Last updated Monday, October 09, 2006
RehabilitationPhysical therapy Early motion after total shoulder replacement is critical for achieving optimal shoulder function.
Arthritic shoulders are stiff. One of the major goals of shoulder
replacement surgery is to relieve much of this stiffness. However,
after surgery scar tissue will tend to recur and limit movement unless
motion is started immediately. This early motion is facilitated by the
complete surgical release of the tight tissues so that after surgery
the individual has only to maintain the range of motion achieved at the
operation. Later on, once the shoulder is comfortable and flexible,
strengthening exercises and additional activities can started. However,
most individuals find the recovery of comfort and function can be
accomplished without formal physical therapy. Rehabilitation options It is often most effective for the individual to carry out her or his
own exercises so that they are done frequently, effectively and
comfortably. Usually, a physical therapist or the surgeon instructs the
individual in the exercise program during the hospital stay and
advances it at a rate that is comfortable for the particular
individual. For the first six weeks after surgery, emphasis is placed
on optimizing the flexibility and range of motion of the shoulder
through gentle stretching exercises. After six weeks, these stretching
exercises are continued and strengthening exercises can be added.Can rehabilitation be done at home? In general the exercises are best performed by the individual at home.
Occasional visits to the surgeon or therapist may be useful to check
the progress and to review the program.Usual response Individuals are almost always satisfied with the increases in range of
motion, comfort and function that is achieved with the exercise
program. If the exercises are uncomfortable, difficult, or painful, the
individual should contact the therapist or surgeon promptly.Risks This is a safe rehabilitation program with little risk.Duration of rehabilitation Once the range of motion and strength goals are achieved, the exercise
program can be cut back to a minimal level. However, gentle stretching
is recommended on an ongoing basis.Returning to ordinary daily activities In general, individuals are able to perform gentle activities of
daily living with the operated arm at the side starting two to three
weeks after surgery. Walking with the arm protected is strongly
encouraged. Driving should wait until the individual can perform the
necessary functions comfortably and confidently. This may take up to
six weeks if the surgery has been performed on the right shoulder,
because of the increased demands on the right shoulder for shifting
gears.
With the consent of their surgeon, individuals may be able to return
to activities such as water exercises and golf as tolerated by their
shoulder at six months after surgery. It is important to remember that
shoulder arthroplasty with a cuff tear arthropathy (CTA) prosthesis
does not restore the function of the degenerated rotator cuff tendons
so that the shoulder will never totally regain full comfort, strength,
range of motion or function. Stressful activities and activities with
the arm in extreme positions may never be possible after this procedure. Long-term patient limitations Individuals should avoid activities that involve major impact (chopping
wood, contact sports, activities with major risk of falls) or heavy
loads (lifting of heavy weights, heavy resistance exercises) after this
surgery. In this way the risk of re-injury is minimized.Costs The surgeon and therapist should provide the information on the usual
cost of the rehabilitation program. The program is quite
cost-effective, because it is based heavily on home exercises.Surgery for Rotator cuff tear arthropathy (arthritis with a massive rotator cuff tear) at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-7416 to make an appointment.
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