- 7. Mai 2023
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Aspirin or certain other pain medicines may increase the chance of bleeding. repair, other BEAR procedure, real ACL reconstructing in pre- chronic models.21,33 . Copyright 2007-2023. These muscles originate on the shoulder blade and attach to the humeral head. Maintain good upright shoulder girdle posture at all times and especially during sling use. Adobe Acrobat 8.0 Combine Files Connect with us. 2 0 obj /-BmN2'ux)>MxYLV#a$F]7W9.|EzuonDxH/?uXPoN,);? 5. /*jthpUxYl*ABB'.4dG^td}AU For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. The camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. Because the sedative may make you drowsy, you'll need to arrange for someone to drive you home. endobj Nikolaidou O, M. S. (2017). Qle_EN ^l The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. Microsoft Word - Rotator cuff and SLAP patient info.doc Call 617-643-3333 if youre experiencing a sports injury. Your health and safety remain our top priority: Learn about our Safe Care Commitment | Use our Prescreen app before arrival for faster entry | Read the COVID-19 Vaccine FAQs. For more information about these cookies and the data Arthroscopic Rotator Cuff Repair Protocol: The intent of this protocol is to provide the clinician with a guideline of the post-operative rehabilitation course of a patient that has undergone an arthroscopic assisted/mini-open rotator cuff repair. Brigham and Womens Hospital has long been committed to not only the care of our patients but also the many other needs that they and their families have. PDF www.mghsportsmedicine.org Arthroscopic Labrum Repair of the Shoulder (SLAP) They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. Ensure wound healing 3. The following Standards is Care and Protocols are the real away BWH and should not be copied or otherwise used without the get of the Director of Rehabilitation Services. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. Stay Informed. An open repair may be done if the rotator cuff injury cant be repaired using arthroscopy. skip to Cookie . PDF Rotator Cuff Repair (Small to Medium) Rehabilitation Guideline endobj Offering comprehensive medical, surgical and psychiatric care as well as complete emergency, ambulatory and diagnostic services to residents of southwest Boston and the surrounding suburbs. When may I start strengthening? Get the latest news, explore events and connect with Mass General. The American Society of Shoulder and Elbow Therapists' consensus statement on rehabilitation following arthroscopic rotator cuff repair. General Information: 3. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. 4. Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. A surgical repair is indicated when pain PDF SUBSCAPULARIS REPAIR REHABILITATION PROTOCOL - Dr. Brian J. Cole The intent of posting these criteria a care and protocols a to provide clinicians and patients an understanding of ours current standards of care and protocols at BWH. (2016). MA Based on your medical condition, your provider may request other specific preparation. A Teaching Affiliate of Harvard Medical School 75 Francis St. Boston, Massachusetts 02115. . endobj Journal of Shoulder and Elbow Surgery, 4:521-535. Healing occurs at a rate of 10% per month. Be sure to discuss any concerns with your provider before the procedure. <>/Metadata 1084 0 R/ViewerPreferences 1085 0 R>> Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. For more information about these cookies and the data These treatments may include: rest, activity modification, non-steroidal anti-inflammatory medication and physical therapy. collected, please refer to our Privacy Policy. If regional anesthesia is used, you'll have no feeling in your shoulder. An open repair may be performed if the rotator cuff injury cannot be repaired using arthroscopy. }@o~+msq8JJ|vd24a2e> Your provider will discuss this with you in advance. Back to Rehabilitation Services Physical Therapy Protocols The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. endstream endobj 770 0 obj<>stream 4 0 obj Tell your provider if you have a history of bleeding disorders or if you're taking any anticoagulant (blood-thinning) medicines, aspirin, or other medicines that affect blood clotting. Your provider will explain the procedure to you. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. {QHCr!3g6jE6YQ` <> The damage may be due to: Inflammation of the bursa (bursitis) in the shoulder, Inflammation of the tendons (tendinitis) in the shoulder. We are committed to providing expert caresafely and effectively. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. Rotator cuff surgery may be performed using an arthroscope. to analyze our web traffic. If you're pregnant or think that you could be pregnant, tell your provider. <> Numerous rehabilitation protocols for the management of rotator cuff disease are based primarily on . Always follow your healthcare professional's instructions. Rotator cuff strengthening with light Theraband - ER and IR with arm at side and pillow or towel roll under arm - Flexion to 60 degrees - Abduction to 60 degrees - Scaption to 60 degrees - Extension to 30 degrees Standing rows with Theraband Prone scapular retraction exercises (with light weight) Ball on wall (arcs, alphabet) Small/Medium Rotator Cuff Repair Protocol; Subscapularis Repair Protocol; Superior Capsule Repair Protocol; Triceps Tendon Repair Protocol; Locations: HAMILTON. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. In arthroscopic shoulder repair, the surgeon inserts a small camera called an arthroscope into the shoulder joint, which displays pictures onto a screen so that the surgeon may guide surgical instruments. `6B3}"{PT(3 _x g"8. This usually involves reattaching the tendon to the head of the humerus. Brigham and Women's Hospital, Division of Rheumatology, Inflammation, and Immunity, nonsteroidal anti-inflammatory medications. Most commonly, however, this group of muscles co-contracts and . ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. 2023 Protect the surgical repair 2. ;#O#t4\i_"+O/G?|tg1}*$27VsO] k\pU2=" PDF Reverse Total Shoulder Replacement Therapy Protocol Rotator Cuff Repair (Arthroscopic) This protocol is based on maintaining range of movement in the first phase and then gradually building strength in the middle to the last phase. Massive Rotator Cuff Repair Protocol Hamilton Orthopaedics, Spine 85 College Street Hamilton, NY 13346. collected, please refer to our Privacy Policy. Abstract. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. A partial tear can occur where the tear damages the soft tissue but does not completely sever it or a full-thickness tear can occur where the soft tissue is split into two pieces and the tendons may tear off where they attach to the head of the humerus. You may undergo blood tests or other diagnostic tests. to analyze our web traffic. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. Elbow/wrist/hand AROM w/ no resistance. The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cannot be controlled by other treatments. Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. HMn0F:N@_A"'( -P7Ul8 >qr5i>M___c*h?) 617-732-5500, Learn more about our sports medicine offerings, Rotator Cuff Tears: Frequently Asked Questions, Rotator Cuff Tears: Surgical Treatment Options, Rotator Cuff and Shoulder Conditioning Program, Anesthesiology, Perioperative and Pain Medicine. endobj In some cases, a tendon graft and joint replacement may be necessary. Phase I: 1 through 4 to 6 weeks post-op: First 3 weeks: Patient education: movement limitations, posture, proper sling fitting, joint protection, and positioning. Boston Rotator Cuff Surgery - Brigham and Women's Hospital 617-732-5500, Rehabilitation Services - Physical and Occupational Therapy, Arthroscopic Anterior Shoulder Stabilization Protocol, Latissimus Dorsi Tendon Transfer Protocol, Open Anterior Shoulder Stabilization Protocol, Posterior and Posterior Inferior Capsular Shift of the Shoulder Protocol, Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Reverse (Inverse) Total Shoulder Arthroplasty Protocol, Rotator Cuff Repair Small to Medium Tear, Rotator Cuff Repair Large to Massive Tear, Ulnar Collatoral Ligament of the Elbow Reconstruction Protocol, Autologous Chondrocyte Implantation Protocol, Medial Patellofemoral Ligament (MPFL) Reconstruction, Post-operative Rehabilitation Protocol following Arthroscopic Hip Surgery for Femoroacetabular Impingement, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Brostrom Gould Repair for Ankle Instability, Functional Activity Progression Protocol following Lower Extremity Stress Injury, Return to Sport Following Knee Injury/Surgery, Running Injury Prevention Tips & Return to Running Program, Running Injury Prevention Tips & Strength Training Program, Reverse (Inverse) Total Shoulder Arthroplasty, Anterior Cruciate Ligament (ACL) Non-surgical Management, Non-Operative Management of Labral Tear of the Hip, Pelvic Floor Considerations in the Transgender and Gender Nonconforming Patient, Breast Reconstruction following Mastectomy, Physical Therapy Treatment of Blocked Milk Ducts, Inpatient-Specific Physical Therapy Standards of Care, Inpatient PT and OT Services: Main Campus, Anesthesiology, Perioperative and Pain Medicine. Rehabilitation after Arthroscopic Labrum Repair of the Shoulder (SLAP) Phase One: 0 to 4 weeks after surgery Goals: 1. PDF Arthroscopic Repair of RTC tear SOC - Brigham and Women's Hospital In older patients, there may not be an injury or event to cause the tear. Tell your provider if you're sensitive to or allergic to any medicines, latex, tape, and anesthetic agents (local and general). HWMo8W(oQ@QIECw^8++kJdGvqd7FWzj7,N.NlI~Kk6}b6}%O, Microsoft Word - Rotator cuff and SLAP patient info.doc. There are a number of different anchoring techniques that surgeons are currently using. Arthroscopic repair of massive rotator cuff tears: outcome and analysis of factors It allows you to lift your arm and reach up. Quick Links. Continue to emphasize scapular stabilizers. Rehabilitation after Rotator Cuff Repair. Your surgeon will make a cut (incision) in the shoulder area. QlR#D' Rotator cuff surgery may be done using an arthroscope. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. Rk.*Ec;g[tG$uVR/vr{O'?= 0?~zEq;*_~f~*axq{qz"ez*^L3_'0/B/''`Do5(C ORs"5>:x8= w l=q6[:!P nh;$+{/Ca p(3QOWhPj0*dpJLOq(X/_l,8Vy/_d0[ g|N!$e$=~HC=:"@("mK0e4o{p$`Y??D :]Lco139R;K)=QUvz x|r =p+43 PDF Rotator Cuff Repair Protocol For more information about these cookies and the data This procedure is specifically designed for the treatment of glenohumeral (GH) joint arthritis or complex fractures, when associated with irreparable rotator cuff (RC) damage or in the presence of RC arthropathy. The anesthesiologist or nurse anesthetist will continuously monitor your heart rate, blood pressure, breathing, and blood oxygen level during the surgery. It's one of the most important parts of the shoulder. This may include shaving off bone spurs that are pinching the shoulder or repairing torn tendons or muscles in the shoulder. Search for condition information or for a specific treatment program. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> x=n8zE$ We use cookies and other tools to enhance your experience on our website and You can ask questions. Mastersling with body . An arm sling is used for 4 weeks post-op. If your rotator cuff is injured, you may need to repair it surgically. It consists of a system of lenses, a small video camera, and a light for viewing. LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv Rotator Cuff Repair - Brigham and Women's Hospital The arthroscope is often used in conjunction with other tools that are inserted through another incision. COPYRIGHT*2014*CRC*"BRIAN*J. mqTdYqc#\*DgVx?,a6&&tO"TP_YV{zYNm[ Dj?mk^(^N7K1_Q P ? +!B8p+*.QnMXNjtt Some possible complications may include: The joint pain and weakness may not be relieved by the surgery. PDF ARTHROSCOPIC ROTATOR CUFF REPAIR - Brigham and Women's Faulkner Hospital NEW HARTFORD. This guideline is designed to Rotator Cuff Repair. PDF Arthroscopic Labral Repair Protocol, II, IV, and complex tears % Day 1 - 3 weeks. Learn about the many ways you can get involved and support Mass General. Mumford Procedure Surgery Rehab Protocol & Recovery Time - Kevin R. Stone Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. ek'eY|&~ll%h$v,*`H. ns6K2*\2 9LSs. Physical Therapy Standards of Care - Brigham and Women's Hospital Van der Meijden OA, W. P . The General Hospital Corporation. Rotator Cuff Repair | ShoulderDoc At Mass General, the brightest minds in medicine collaborate on behalf of our patients to bridge innovation science with state-of-the-art clinical medicine. Tech How Assam. collected, please refer to our Privacy Policy. Rotator Cuff Tears - New England Baptist Hospital The incision will vary depending on the type of surgery (open surgery, arthroscopy, or a combination of both) that may be done. You may get a medicine (sedative) before the procedure to help you relax. The rotator cuff consists of muscles and tendons that hold the shoulder in place and allows a person to lift his and her arm and reach up. Regain range of motion 5. Tell your provider about any of the following: Redness, swelling, bleeding, or other drainage from the incision site, Numbness or tingling in the affected arm or hand. Rotator cuff tears (RCT) are frequent and increase with age, yet the varying functional implications of a tear can have a unique and dramatic impact on a patient's daily life. augment suture repair of the rotator armband tendon in 2 stud-. Dr. O'Holleran is Fellow, Harvard Shoulder . PDF Biceps Tenodesis Protocol - Brigham and Women's Hospital Stay Informed. The arthroscope (if used) will be put through the incision. Let us help you navigate your in-person or virtual visit to Mass General. There may be other reasons for your healthcare provider to recommend rotator cuff repair. The circulation and sensation of your arm will be monitored. Other activity restrictions may apply. You may resume your normal diet unless your provider advises you differently. Arthroscopic Anterior Shoulder Stabilization Protocol, Latissimus Dorsi Tendon Transfer Protocol, Open Anterior Shoulder Stabilization Protocol, Posterior and Posterior Inferior Capsular Shift of the Shoulder Protocol, Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Reverse (Inverse) Total Shoulder Arthroplasty Protocol, Rotator Cuff Repair Small to Medium Tear, Rotator Cuff Repair Large to Massive Tear, Ulnar Collatoral Ligament of the Elbow Reconstruction Protocol, Autologous Chondrocyte Implantation Protocol, Medial Patellofemoral Ligament (MPFL) Reconstruction, Post-operative Rehabilitation Protocol following Arthroscopic Hip Surgery for Femoroacetabular Impingement, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Brostrom Gould Repair for Ankle Instability, Functional Activity Progression Protocol following Lower Extremity Stress Injury, Return to Sport Following Knee Injury/Surgery, Running Injury Prevention Tips & Return to Running Program, Running Injury Prevention Tips & Strength Training Program, 2023Brigham and Women's Faulkner Hospital. . PDF Rehabilitation Protocol Lower Trapezius Tendon Transfer to Greater Brigham and Women's Faulkner Hospital Rehabilitation Services 1153 Centre Street - 2nd Floor Boston, MA 02130 617-983-7271 General Information Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. Our inpatient satisfaction survey, sent to patients to assess their total care experience, helps us to monitor what we are doing well and what areas may need improvement. The skin over your surgical site will be cleaned with an antiseptic solution. Once youre home, its important to keep the surgical area clean and dry. PDF Rotator Cuff Repair Protocol - Boston Shoulder Institute application/pdf to analyze our web traffic. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Mass General - Boston The intent of posting these standards of care and protocols is to provide clinicians and patients an understanding of our current standards of care and protocols at BWH. Today, the Center a collaboration of the Department of Orthopaedic Surgery and the Division of Rheumatology, Inflammation, and Immunity - is known for its pioneering team of physicians and researchers dedicated to doing everything possible for our patients while helping to develop and apply the most advanced treatments for bone and joint diseases and conditions. When one or more of the tendons in the rotator cuff is torn, it no longer fully attaches to the head of the humerus. Anesthesia, Critical Care & Pain Medicine, Billing, Insurance & Financial Assistance, Autologous Chondrocyte Implantation (ACI)-Femoral, Autologous Chondrocyte Implantation (ACI)-Patella, Medial Patellofemoral Ligament (MPFL) Reconstruction, Microfracture of Femoral Condyle & Patella/Trochlear Groove, Osteochondral Autograft/Allograft Transfer System (OATS) Procedure, Acromioclavicular Joint Reconstruction (including Coracoclavicular Ligament Reconstruction), Clavicle Open Reduction Internal Fixation (ORIF), Proximal Humeral Fracture Open Reduction Internal Fixation (ORIF), Rotator Cuff Repair - Small to Medium Tear, Rotator Cuff Repair - Large to Massive Tear, Ankle Fracture with Open Reduction and Internal Fixation (ORIF), Medial & Lateral Epicondylitis (Golfers Elbow), Athletic Pubalgia (non-operative management), Hip Arthroscopy for Femoroacetabular Impingement, Interval Throwing Program Phase One - Long Toss, Interval Throwing Program Phase Two - Pitcher's Mound, Interval Throwing Program for Little League. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. Stay Informed. For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. If medical treatments aren't working, rotator cuff repair surgery may be an effective treatment. This rehabilitation protocol has been developed for the patient following a large to massive rotator cuff surgical procedure. Turners Cuff . Extensor Tendon Injury Protocol | PDF | Thumb | Hand - Scribd Stay Informed. Injuries to the shoulder are common. Individually, these muscles either internally or externally rotate the humerus. 2000-2023 The StayWell Company, LLC. vywh0*-)Ha[ %2+$t^> K5$*{c Z Q.@B[,4nr^{.zlqE@`Cu.> Boston, Include home cuff strengthening program. %PDF-1.7 The goal of rotator cuff repair surgery is to help restore the function and flexibility of the shoulder and to relieve the pain that cant be controlled by other treatments. Rotator cuff repair may be done on an outpatient basis or as part of your stay in a hospital. We offer diagnostic and treatment options for common and complex medical conditions. 3 0 obj You may meet with a physical therapist before your surgery to talk about rehabilitation. This protocol will vary in length and aggressiveness depending on factors such as: Rehabilitation Services at Brigham & Women's Hospital has accepted a modification of this protocol as our standard protocol for the management of patient's s/p arthroscopic repair of Type II and IV SLAP lesions. Physical Therapy Protocols Shoulder Elbow Hip/Knee Ankle Return to Sports Guidelines Physical Therapy Standards of Care Ankle Spine Shoulder Hip/Knee Lower Extremity Pelvic Health 4 0 obj The rotator cuff keeps the shoulder in the socket. Other incisions may be made to use other small grasping, probing, or cutting tools. This may include shaving off bone spurs that are pinching the shoulder, and repairing torn tendons or muscles in the shoulder. They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services.
