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Postoperative Rehabilitation of Patients with Shoulder Arthroplasty ? A Review on the Standard of Care

Kraus M, Krischak G and Tepohl L

Shoulder replacement is the third most common joint replacement worldwide following hip and knee replacements. Compared with hip and knee the rehabilitation for shoulder prosthesis is discussed controversially and depends strongly on the precepts of the surgeon. The objective of this paper is to determine the current standard of care of rehabilitation following shoulder arthroplasty based on a systematic review. The PubMed database was searched with the terms‚ [rehabilitation] and [shoulder prosthesis]’, ‘[rehabilitation] and [glenohumeral joint replacement]’, ‘[shoulder prosthesis] and [physiotherapy]’ and ‘[total shoulder replacement] and [rehabilitation]’. In total 1,026 papers were found in the primary search, crosschecking all relevant results another 1,332 papers were detected. All papers were scanned manually for relevance on the topic. Finally, ten papers were included which were in accordance with the inclusion criteria. All indications leading to shoulder replacement as well as all types of replacement procedures were included. In summary there are many parallels between different rehabilitation protocols which can be used as a general guideline. Based on the consensus regarding intensity of physiotherapy, post-operation immobilization and total rehabilitation time a three-phase-protocol, which starts passive and increases to active-assisted and to active, was extracted. Up to now no publication shows the influence of rehabilitation following shoulder prostheses. Therefore, prospective studies are needed.