Sunday, July 6, 2014

How long does it take to get better after a shoulder joint replacement

Speed of recovery after shoulder arthroplasty: a comparison of reverse and anatomic total shoulder arthroplasty

These authors tracked the recovery of 122 patients treated with primary reverse total shoulder (RSA) and 166 patients treated with primary anatomic total shoulder arthroplasty (TSA) with a minimum of 1 year of follow-up.

By 6 months, TSA patients had achieved 90% to 100% of functional improvement, whereas RSA patients reached 72% to 91%. 

Comment: While this study attempts to compare the results with the two types of arthroplasty, it is apparent that the two patient groups are not comparable. The average age of the RSA group was 76 years in comparison to 70 for the TSA group (p<.001). 69% of the RSA patients were female in comparison to 49% for the TSA group (p<.001). The patients having TSA had intact cuffs whereas those having RSA had rotator cuff deficiency together with subluxation, glenohumeral arthritis, or pseudoparesis (<90° of elevation). The preoperative self-assessed shoulder function by the Simple Shoulder Test for the RSA group was half that of the TSA group. So it is no surprise that the RSA group improved more slowly and less completely than the TSA group. 

What is of note is that the TSA group achieved most of their improvement in the first 6 months as shown below. While we do not know the details of the rehabilitation program used, the chart below is of interest.


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