rotator cuff repair protocol pdf

Your Patient is part of a study evaluating the eﬀect of timing of post‐operative therapy after rotator cuﬀ repair. The repair progression is dependent on a number of factors including the patient’s age, tissue quality, size of the tear, acute vs chronic condition, strength and ROM status pre-op, ATS vs open repair procedure, and performance/activity demands. Precautions: 250 South Main St. Suite 224A Blacksburg, VA 24060 540-552-7133 All information contained in this protocol is to be used as general guidelines only. Even with advances in … 0000007693 00000 n It is subject to modification depending on the degree of injury, the type and extent of associated surgical intervention, as well as your individual progress post … ARTHROSCOPIC AND OPEN ROTATOR CUFF REPAIR REHABILITATION PROTOCOL WEEK 1 - 2 Shoulder sling and swathe full time day and night. 0000251427 00000 n Phase I – Immediate Postoperative Phase (Weeks 0 – 6) Days 0-14 Patient is seen 2 days post-operative to remove surgical dressings and pain catheter. 0000004857 00000 n The path to regaining range of motion, strength and function can require a sustained and coordinated effort from the patient, his or her family, the Ohio State Sports Medicine physical therapy team and sometimes, other healthcare providers. the rotator cuff. SAD (Subacromial Decompression) Protocol Phase I (post-op until week 2) Protective phase ‐ Sling use for 0‐7 days as needed (or as directed by MD) ‐ Elbow and hand ROM and hand squeezing exercises ... ‐ Advance with shoulder rotator cuff… The patient is seen 2- Remove the sling 4 or 5 times a day to do pendulum exercises. 0000251469 00000 n This book is a compilation of the experiences, thoughts, and "best-practice" advice of a panel of international experts on medical and surgical education. Prevent stiffness and regain motion Activities: 1. Rotator Cuff Repair Rehabilitation Protocol The following document is an evidence-based protocol for arthroscopic rotator cuff repair rehabilitation. rotator cuff and strengthening and retraining the scapular musculature. Purpose of the abductor pillow is to keep tension off of the repair, avoid adduction. Brace • Abduction brace/sling, remove sling only to bathe and to complete exercises. The tear (A) is approximated. 0000070674 00000 n 4��v� ��Fc}�קօ��{��_9؆v�|��*e��Bl�~Vv4�b)�$l�a>ߢ3�q��(��ھ1��?=�X�N�>H��ko�j9�t�Z]r�tI-�BN��{�| �Lv�E/)��C Gc�bk� ��T̖�c{X��-��JH�=,��w�w��1��W�C��\.i04N^'Wɝ�+�Mw.��'��Ō֘sk +JfR�p��L�b�!m��4��qho��ݚu��Qc0GA��h/��2Bm?2 ~/@�!l��. j@FYjN~Anj^��3PuNNf�BzNeAF�BbJJj For this reason the shoulder is the most mobile joint in the body. 0000002698 00000 n Rehab Progression Summary . 0000011161 00000 n REHABILITATION GUIDELINES FOR MINI-OPEN ROTATOR CUFF REPAIR FOR TYPE II TEARS (+/- SUBACROMIAL DECOMPRESSION) The rehabilitation guidelines are presented in a criterion based progression. <<85D12C06A5FC5F44B0E5EB4E2D26334A>]>> xref 55 0 obj<>stream Rehabilitation protocols. A large size rotator cuff tear is defined as a tear 3 - 5cm, massive >5cm. In addition, isometric strengthening exercises begin at this time. .�ř�y 0000001586 00000 n Sling: Use your sling all of the time except for when doing therapy. The Rotator Cuff Therapist Directed Program was created by the MOON Shoulder Group. 0000004743 00000 n Large and Massive Open Rotator Cuff Repair (> 5 cm) Post-Operative Rehabilitation Protocol SUBSCAPULARIS INVOLVEMENT PRECAUTIONS: 1. 0000001340 00000 n 0000017664 00000 n 0000001276 00000 n Found insideThroughout the book the authors focus on the value of the procedures to patients, showing ways that expense and risk can be minimized. Found inside – Page iiiContributing to the unique nature of this highly instructive book, three patients with sciatica and chronic pain are followed serially throughout the text to illustrate important concepts that are discussed. Arthroscopic Rotator Cuff Repair Protocol: Copyright © 2007 The Brigham and Women's Hospital, Inc. Department of Rehabilitation Services. Found inside – Page 737Available at: www.census.gov/prod/ cen2010/briefs/c2010br-09.pdf. 8. Jain NB, Higgins LD, Losina E, Collins J, Blazar PE, Katz JN. Epidemiology of musculoskeletal upper extremity ambulatory surgery in the United States. ROTATOR CUFF REPAIR POST-SURGICAL REHABILITATION PROTOCOL POST-OP DAYS 1 - 21 • Immobilizer with abductor pillow x 4-6 weeks – Even while sleeping – Place pillow under shoulder / arm while sleeping for comfort • Hand squeezing exercises • Elbow and wrist active motion (AROM) with shoulder in neutral position at side The new edition of the well-respected Brotzman has been updated to consistently include evidence-based rehabilitation protocols, as well as comprehensive coverage and videos at a great value! •Variety of tissue types (dermis, fetal dermis small intestine submucosa [SIS], pericardium), donor species (allograft, xenograft), and processing techniques. 0000079297 00000 n 0000069975 00000 n Found inside – Page iiThe book offers a comprehensive and up-to-date guide to the cutting edge arthroscopic transosseous techniques for the treatment of rotator cuff tears, which are gradually taking over from the common open surgical approach, defined as the ... SPECIAL CONSIDERATIONS • Massive cuff tear: delay protocol by 2 weeks unless otherwise directed by surgeon. ROTATOR CUFF REPAIR Most rotator cuff tears can be repaired surgically by reattaching the torn tendon(s) to the humerus. might predict failure of rotator cuff repairs the MOON Shoulder Group met in San Diego, California on February 15, 2007 where we reviewed the best evidence and developed a standard consensus‐based postoperative protocol for patients after rotator cuff tear repair: Found insideThis comprehensive, practical volume is enhanced with striking illustrations, detailing the surgical technique from positioning to closure. 0000016239 00000 n MOON Shoulder Post-operative Rotator Cuff Repair Protocol – Therapist Instructions 4 Active Motion (8-12 weeks) While continuing to work on active assisted range of motion, the patient now begins active range of motion in forward elevation, external rotation and abduction. Arthroscopic Rotator Cuff Repair Protocol Medium to Large Tear Size This protocol was developed to provide the rehabilitation professional with a guideline of postoperative rehabilitation course for a patient who has undergone an arthroscopic medium to large size rotator cuff tear repair. May shower out of sling with surgeon’s ok. WEEK 3 - 4 INTITATE FORMAL PHYSICAL THERAPY Rotator Cuff Repair Arthroscopic This protocol is based on maintaining range of movement in the first phase and then gradually building. 0000001680 00000 n Phase I: Days 1 to 28 Days 1 to 6 . REPAIR GUIDELINE . The operation aims to re-attach the tendon(s) to the bone. ROTATOR CUFF REPAIR POST-SURGICAL REHABILITATION PROTOCOL POST-OP DAYS 1 - 21 • Immobilizer with abductor pillow x 4-6 weeks – Even while sleeping – Place pillow under shoulder / arm while sleeping for comfort • Hand squeezing exercises • Elbow and wrist active motion (AROM) with shoulder in neutral position at side Found insideThe Cowboy's Companion: A Trail Guide for the Arthroscopic Shoulder Surgeon is truly a companion book to Burkhart’s View of the Shoulder: A Cowboy's Guide to Advanced Shoulder Arthroscopy, which builds on the principles of the first book ... As dim as strictly follow the surgeon's rehab protocol as peach was the regiment who. If these two aims are fully achieved, then shoulder function should slowly come back to normal, or near normal, with strength improving over about 15 months. Rotator Cuff Repair Protocol p. 1 Rotator Cuff Repair Protocol Applicability: Physician Practices Date Effective: 11/2016 Department: Rehabilitation Services Date Last Reviewed / or Date Last Revision: Supersedes: Rotator Cuff Repair (Beattie) 11/2016 Administration Approval: Amy Putnam, VP Physician Services Purpose: Define the protocol to be followed for all patients referred from … 0000002469 00000 n Rotator cuff tears are most prevalent in the over 40 population. The procedure restores the efficiency �� 1m�~�I �H� �EgL�NO��*Q�i&�m�z#�b�@`�Egd��8:�tG�� 1;�� ^�" -Ī`�"@'X40l`X��Ű� � ��~?�N"��| LrS�L��`�f��a��s�@f80 Imw��8��e` ��@� +U3� Rotator Cuff Repair Protocol . Arthroscopic Rotator Cuff Repair Protocol: The intent of this protocol is to provide the therapist and patient with guidelines for the post-operative rehabilitation course after arthroscopic rotator cuff repair. The procedure involves stitching the torn tendon back onto its attachment to the humerus. 0000016640 00000 n Please instruct the patient in proper form and technique 0000018067 00000 n Found inside – Page 1965The evolution of the Bobath concept is brilliantly captured in this volume. The book features valuable contributions from stem cell therapy experts from around the world. The authors explain the production, proliferation, differentiation into various tissues, and medical applications of stem cells. *COLE,*MD,*MBA RANGE OF MOTION IMMOBILIZER EXERCISES PHASE I 0-4 weeks 0-2 weeks: None 2-4 weeks: begin PROM Limit 90° flexion, 45° ER, 20° extension, 45° abduction, 45° ABER 0-2 weeks: Immobilized at all times day and night Off for … "This ... text builds on Mosby's CRITICAL PATHWAYS IN THERAPEUTIC INTERVENTION -- Upper Extremities and adds comprehensive coverage of the lower extremity and spine. [The format is such that] unique case study chapters simulates the signs ... Starting the first day after surgery you should remove the sling 3-4 times per day to perform pendulum exercises and elbow/wrist range of motion (unless otherwise specified by Dr. Robertson). Rotator Cuff Repair Rehabilitation Protocol (Arthroscopic Repair) Note to therapists: You may ask patients to bring arthroscopic photos with them for your review and contact our office regarding operative reports or any questions. Medium Sized Full Thickness Rotator Cuff Repair Protocol. 22 34 r��\Y�W`�`�>��,>��x��x�y�y�y�y�y�)�(�(��yżr^�yvQtQvQtQvQtQvQtQvQt� y~#��Q�Q�Q�Q�Q�Q�Q��o�7��o�7��o�7��WxN��Z��y�� V�yƚ�4��\�Du}�. 0000010510 00000 n �� EPu� 3 • Initiate active assisted range of motion (AAROM) flexion in supine position • Progressive passive ROM until approximately Full ROM at Week 4-5. drjeffreywitty.com General Notes: - Sling used for 6 weeks total o Removed only for showers and, when comfortable, meals o Instructions for self care and sling removal can be found on drjeffreywitty.com 0000251407 00000 n Rotator Cuff Repair Please remember, individual patients will progress differently and their post operative protocol will be dependent on both the size of the tear and how secure the repair is. Rotator cuff repair is performed by this post rotator cuff tear and found an aching muscle �T�t�e�cq��a��ٳ� J�o4��.miG��-��. If patient has a concomitant injury/repair (such as a rotator cuff repair) treatment will vary- consult with surgeon. x�b```f``�c`e`�8� Ā B@16�L 0000029355 00000 n A;|�:ޕ^��Z��S��kވ�'&:BW8u�p��+3:��_n��#6m[ZnC�ӾMȽ��x�6��k�ҩ�:��ۙ��S��z�m�^m�(��vnšA*G�T�&�U��Џ)��kzM�٦K7wyۆ��R��vM�Xm��բR��YΕ�x*��f�KI�nX9�X�+��R�`c��O�QJYls��ܷ��6��3��5R},�ҳwS�:�m��GT/R�TL|�f��j�tI-{V-�ҭ��.ZSz8��!��C��l��5+S��:��Ϧ�(��=Vkb��IJM��0��m�N�o9^��}��+�R�,�FUT��3;�UvF�'ڕ��fj��l��B�fj�Nc'-B%�0[�V��OmE��E-�=#��[ Q݄M�Gq��/��d`��=�Qe��e�Ѭh��/ѭI�y��Fi�aF��u�X�h� Sling Use: Small tear- 2-3 weeks (educate that patient should continue to avoid active shoulder arthroscopic rotator cuff repair. The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. It is not a big operation to repair a torn rotator cuff, but the rehabilitation time can be long depending on the size of the tear and the quality of the tendons/muscles. The socket portion of the joint is not naturally deep. If pain, weakness, and stiffness in your shoulder (See figure in appendix) are related to problems with your rotator cuff, a doctor will usually first recommend nonsurgical treatment. Please note this protocol is a guideline. Strengthening. education: encourages frequent ice use, postural awareness, compliance with precautions, use and weaning from sling depending upon repair size. "This book was written to teach people with Ehlers-Danlos Syndrome (EDS) how to systematically progress through an exercise program to allow their muscles to support many joint subluxations commonly associated with this genetic disorder. No lifting of objects no matter the size or weight. Passive Range of Motion: • Pendulum exercises Active Range of Motion: • Cervical, elbow, fingers and hand. Found inside – Page iiiThis book is a comprehensive guide to proprioceptive rehabilitation after orthopaedic and sports surgery. Rotator Cuff Repair Post-operative Rehabilitation Protocol. Post-Operative Rotator Cuff Repair Rehabilitation Protocol CANADIAN SURGERY SOLUTIONS #300, 1402 8th Ave NW Calgary, AB T2N 1B9, PH: 403-220-0410 TOLL FREE: 888-224-0310 FAX: 403-220-0500. Found inside – Page iiiThis book serves as a definitive guide to diagnosing shoulder conditions for all levels of orthopaedic surgeon with an interest in shoulder pathology, and for junior surgeons in training. TYPE ONE - ROTATOR CUFF REPAIR ARTHROSCOPIC OR MINI-OPEN Small Tear (Less than 1 cm) I. 0000029394 00000 n This may be performed arthroscopically or through open surgery, using sutures and bone anchors. Video pre and post repair. Immobilizer at all times for 4-6 weeks Found insideThis book is designed to help improve the medical care of athletes across the world who play team handball – including not only handball itself but also such sports as beach volleyball and mini-handball. H[XbNj��[fNfAA~��.�0�V�+�M-��Q��K��,�TH�KQ��MMOT�MLI��YRT�`b��헙�TZ� ��_��BPjziNb�� #��0��(0�X�|3j3&|��ݳ�g>d��o�Z��Ν4�j7ǂ)5��"ٻ��K��j�j;�8j��n�S=�{7Ǐ7� S��Xt��?�ˊ�MH�k��˓��wߔ|ouC9$�49M. The procedure involves stitching the torn tendon back onto its attachment to the humerus. ROTATOR CUFF REPAIR A rotator cuff repair is designed to improve pain and function in cases of rotator cuff tears. This may be performed arthroscopically or through open surgery, using sutures and bone anchors. 0000003813 00000 n D�P�ZEvP ��R��~�TQ��l�V� Rotator Cuff Repair Physical Therapy Protocol Dr. Allan Hunt Phase I 0-2 Weeks- Maximum protection Educate the patient on self-care/hygiene, supporting shoulder with sling/abductor support, warning signs including fever, erythema and excessive/unrelenting pain, use of TENS unit No motion. ROTATOR CUFF REPAIR . COPYRIGHT*2014*CRC*©BRIAN*J. 0000012115 00000 n 0000058280 00000 n 0000070401 00000 n This means a camera and instruments are placed into the shoulder joint through small incisions and used to repair the Rotator Cuff. D�KGD��U�ӱ��;��\��w�>�#$|�9�=�yϑ1V�L&��9G�'-y��2q��8�2��7�gG2�� "v��A��g�!�/��L��h�. This protocol is designed for the patient following arthroscopic rotator cuff repair. Collagen Scaffolds Biologics in Rotator Cuff Repair •Goal: augment the biomaterial properties of mechanically compromised rotator cuff tendons. Complications following arthroscopic rotator cuff surgery are very rare. Such complications occur in less than 1% of cases. These complications include instrument breakage, blood vessel or nerve damage, blood vessel clots, infection, and inflammation. Complications, though still rare, are more common following open surgery. Ohio State physicians and physical therapists work collaboratively to develop best clinical practices for post-surgical rehabilitation. Arthroscopic Rotator Cuff Repair Protocol Medium to Large Tear Size This protocol was developed to provide the rehabilitation professional with a guideline of postoperative rehabilitation course for a patient who has undergone an arthroscopic medium to large size rotator cuff tear repair. ibicom M\n{Ç În£ äÎnn \n{Ç În£ än££ Rotator Cuff Repair: Medium Tear Post-Operative Rehabilitation Protocol Illinois Bone & Joint Institute The deltoid muscle is separated to expose the torn rotator cuff tendon(s). SLAP Repair Protocol . 0000009800 00000 n Rehabilitation Guidelines for . Small to Moderate Rotator Cuff Repair, M. Lemos, MD, K. Gagnon, PT, K. Keen, PT, E. Lang, DPT 12_2019 8 Rehabilitation Protocol for Small to Moderate Rotator Cuff Tear: Summary Table Post –op Phase/Goals Range of Motion Therapeutic Exercise Precautions Protective Phase 0 – 6 Weeks Goals : Protection of surgical site All rights reserved. Rotator Cuff Repair: Rehabilitation Protocol Michael Angeline, MD Department of Orthopedic Surgery Prepared by Dalton Venden, LAT PHASE 1 Surgery to 2 Weeks After Surgery Goals: • Protect the integrity of the repair • Reduce pain and edema post-surgery • Maintain grip strength • Continue to stay in sling until 3-4 weeks post-surgery Phase I – Immediate Postoperative Phase (Weeks 0 – 6) Days 0-14 Patient is seen 2 days post-operative to remove surgical dressings and pain catheter. Pictures courtesy of SimpleSet, used with permission. You will follow-up with Dr. Robertson 10 -14 days after surgery. Active assist ROM beginning week 7 after surgery (weeks 7-8) c. Active ROM beginning week 9 after surgery (weeks 9+) Weeks 0-6: a. Precautions: i.
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