Document Detail

Is a formal physical therapy program necessary after total shoulder arthroplasty for osteoarthritis?
MedLine Citation:
PMID:  19800258     Owner:  NLM     Status:  MEDLINE    
HYPOTHESIS: A retrospective analysis was conducted of 2 consecutive groups of patients undergoing total shoulder arthroplasty (TSA) for primary osteoarthritis. One group was treated with formal physical therapy (PT), and one group was treated with home-based, physician-guided PT. We hypothesized that patients with a formal postoperative PT protocol would have significantly better postoperative clinical outcomes than patients with no formal PT. METHODS: Group A (43 patients) had a standard PT program. Group B (38 patients) had a home-based, physician-guided PT program. Clinical outcomes (preoperatively, 3, 6, and 12 months and most recent follow-up) were analyzed. A minimum sample size of 31 patients gives power to detect a 10-point American Shoulder and Elbow Surgeons (ASES) score (alpha=0.05, beta=0.80). RESULTS: ASES and Simple Shoulder Test (SST) scores significantly improved in both groups at all follow-up periods. Forward flexion and abduction were significantly improved in group B at all time points, whereas an initial improvement in forward flexion and abduction in group A was lost at final follow-up. There were no significant differences in final ASES or SST scores between groups at final follow-up. However, forward flexion, abduction, and the Short Form-36 physical component summary in group B were significantly better than group A at final follow-up. No significant improvements in internal rotation or SF-36 mental component summary were seen within or between the groups at final follow-up. Overall, there was no difference in patient satisfaction, with 88% satisfaction in group A and 95% satisfaction in group B (chi(2)=0.471, P=.4924). CONCLUSIONS: A home-based, physician-guided therapy program may provide adequate rehabilitation after TSA, allowing for a reduction in cost for the overall procedure.
Philip J Mulieri; Jason O Holcomb; Page Dunning; Michele Pliner; R Kent Bogle; Derek Pupello; Mark A Frankle
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Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-10-02
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  19     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-17     Completed Date:  2010-09-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  570-9     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Shoulder & Elbow Division, Florida Orthopaedic Institute, Tampa, FL, USA.
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MeSH Terms
Arthroplasty, Replacement / methods*
Follow-Up Studies
Middle Aged
Osteoarthritis / physiopathology,  rehabilitation*,  surgery
Patient Satisfaction
Physical Therapy Modalities*
Program Evaluation*
Range of Motion, Articular
Recovery of Function
Retrospective Studies
Shoulder Joint*
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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