"How long will it take my shoulder to recover after joint replacement?" This important topic has been explored by the authors of Speed of recovery after shoulder arthroplasty: a comparison of reverse and anatomic total shoulder arthroplasty. They found that anatomic total shoulder (TSA) patients reached a consistent plateau for pain and function by 6 months and for shoulder elevation by 1 year. Reverse total shoulder (RSA) patients demonstrated variability with multiple false plateau points. By 6 months, TSA patients had achieved 90% to 100% of functional improvement, whereas RSA patients reached 72% to 91%. The effectiveness of TSA was greater than that of RSA for all measures with the exception of elevation and abduction.
A recent post considered the questions patients most frequently asked about shoulder arthroplasty: Information that patients want to know about shoulder joint replacement arthroplasty for arthritis. One of the commonly asked questions was about recovery: How long does it take to recover from a shoulder joint replacement? When this question was posed to ChatGPT, the response was "Full recovery (6-12 months): While the majority of recovery is typically achieved within the first six months, it can take up to a year or longer to fully regain strength, range of motion, and function."
The authors of recent article sought to answer this question in their practice: Rate of improvement in shoulder strength after anatomic and reverse total shoulder arthroplasty, a study of 374 shoulders having primary anatomic TSA (aTSA) and 601 shoulders having primary reverse TSA (rTSA).
A handheld dynamometer was used to assess
(1) external rotator (ER) strength with the involved shoulder in 0 degrees of external rotation, 0 degrees of abduction, and the elbow in 90 degrees offlexion and
(2) forward elevation (FE) strength with the involved shoulder in the scapular plane at 30 degrees of flexion and 30 degrees of abduction.
aTSA patients had the greatest gains in strength in the first year postoperatively. Strength increased the most between 3 and 6 months. At two year followup patients having aTSA had a 32% improvement in ER and 38% improvement in FE.
rTSA patients also had the greatest gains in strength in the first year postoperatively. ER strength improved the most between 6 months and 1 year; FE strength increased the most between baseline and 3 months. At two year followup patients patients having rTSA had a 51% improvement in ER and 90% improvement in FE.
These data on the recovery of strength are consistent with the recovery in measures of comfort and function as reported by the authors of Rate of Improvement in Clinical Outcomes with Anatomic and Reverse Total Shoulder Arthroplasty who studied 505 anatomic total shoulders and 678 reverse total shoulder arthroplasty.
Full improvement was typically achieved by 24 months, although the majority of improvement was achieved in the first 6 months.
Comment: These two studies help answer patients' questions about the typical recovery of strength, comfort and function after shoulder arthroplasty, It is worth emphasizing that
(1) shoulder arthroplasty (aTSA or rTSA) is most commonly performed on shoulders that have been disabled for years during which time the joint typically becomes weak and stiff - limitations that can only be overcome by a gentle, persistent postoperative rehabilitation program extending for months after surgery
(2) post-arthroplasty recovery is variable among patients because of differences in diagnoses, procedures, co-morbidities, resilience and effort, so "average" recovery may not pertain to each individual patient.
(3) it is useful for surgeons to monitor recovery for the first year after surgery using a convenient patient reported outcome measure to be sure that the patient is on track and, if not, to investigate the possible reasons why not.
(4) early identification of patients who are "off track" may indicate the need for interventions to optimize the opportunity for a good longer term outcome as emphasized in Which patients have poorer early results from total shoulder arthroplasty and how do these patients fare at two years after surgery?
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Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: click on this link
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/
Here are some videos that are of shoulder interest
Shoulder arthritis - what you need to know (see this link).
How to x-ray the shoulder (see this link).
The ream and run procedure (see this link).
The total shoulder arthroplasty (see this link).
The cuff tear arthropathy arthroplasty (see this link).
The reverse total shoulder arthroplasty (see this link).
The smooth and move procedure for irreparable rotator cuff tears (see this link).
Shoulder rehabilitation exercises (see this link).
