brigham and women's rotator cuff repair protocol

Take a pain reliever for soreness as recommended by your healthcare provider. The shoulder is a ball-and-socket joint: the head of the humerus (upper arm bone) fits into a socket in the shoulder blade. mqTdYqc#\*DgVx?,a6&&tO"TP_YV{zYNm[ Dj?mk^(^N7K1_Q P ? +!B8p+*.QnMXNjtt Qle_EN ^l Stay Informed. Maintain good upright shoulder girdle posture at all times and especially during sling use. Van der Meijden OA, W. P . General Information: There are a number of different anchoring techniques that surgeons are currently using. Stay Informed. If regional anesthesia is used, you'll have no feeling in your shoulder. Medical treatments for rotator cuff injury may include, but are not limited to, the following: If medical treatments are not satisfactory, rotator cuff surgery may be an effective treatment for shoulder repair. This may include shaving off bone spurs that are pinching the shoulder or repairing torn tendons or muscles in the shoulder. MA Frequency of treatment will be determined by your specific needs together with the physician and physical therapist recommendations. augment suture repair of the rotator armband tendon in 2 stud-. 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 skip to Cookie . It allows you to lift your arm and reach up. MD follow-up visits at Day 1, Day 14 . % 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. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities and eventually require rotator cuff surgery. stream Arthroscopic Rotator Cuff Repair is performed when there is a tear of one or more of the four muscles that comprise the Rotator Cuff. It may be necessary for you to stop these medicines before the procedure. 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. This results in weakness or numbness. 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. 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. For more information about these cookies and the data A Teaching Affiliate of Harvard Medical School 75 Francis St. Boston, Massachusetts 02115. . This protocol is time based (dependent on tissue healing) as well as criterion based. For surgery at the surgery center at Brigham and Women's Hospital/MGH Foxborough Report directly to the 4th Floor SHOULDER - ROTATOR CUFF REPAIR WITH SLAP REPAIR POSTOPERATIVE INSTRUCTIONS Phase One: the first week after surgery GOALS: Control pain and swelling Protect the rotator cuff repair Protect wound healing (2016). It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. ;#O#t4\i_"+O/G?|tg1}*$27VsO] k\pU2=" Get the latest news, explore events and connect with Mass General. A sterile bandage or dressing will be applied. to analyze our web traffic. uuid:463caef0-aa5d-4b8f-bc94-142f9b3774d9 COPYRIGHT*2014*CRC*"BRIAN*J. <>/XObject<>/Font<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/Annots[ 32 0 R 33 0 R 34 0 R] /MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> 3 0 obj Let us help you navigate your in-person or virtual visit to Mass General. After surgery you'll be taken to the recovery room for observation. For more information about these cookies and the data Most commonly, however, this group of muscles co-contracts and . There may be other reasons for your healthcare provider to recommend rotator cuff repair. The conservative rehabilitation protocol allows Sharpey fibers to form before stressing the repair with resistive exercises. Brigham and Womens Hospital is committed to providing all of our patients with the safest, highest-quality, most-satisfying care possible and following established protocols that have been shown to improve patient outcomes. It stabilizes the ball-and-socket joint of the shoulder and allows for normal shoulder mechanics. As with any surgical procedure, complications can happen. Rk.*Ec;g[tG$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 Its one of the most important parts of the shoulder. PROM shoulder flexion/abduction/ER/IR. 1 The intent of this Protocol is to provide the clinician with a guideline for the post-operative rehabilitation course of a patient that has undergone a Flexor Tendon Repair.It is by no means Brigham AND women 'S HOSPITAL intended to be a substitute for one's clinical decision-making regarding the progression of a A Teaching Affiliate of Harvard Medical School patient's post-operative course . We provide our patients with comprehensive, coordinated care from experts who understand the unique needs of women in sports. The Orthopaedic & Arthritis Center at Brigham and Womens Hospital is one of the most highly regarded orthopaedic and joint disease research and treatment programs in the world. Once your blood pressure, pulse, and breathing are stable and you're alert, you'll be taken to your hospital room or discharged to your home. Copyright 2007-2023. 1 0 obj The conservative approach may be associated with post-operative stiffness which can be managed once healing has occurred. /*jthpUxYl*ABB'.4dG^td}AU If the rotator cuff is injured, it may need to be repaired surgically. Acrobat Distiller 8.0.0 (Windows) ajp5 Thigpen, C. A. Your surgeon will make a cut (incision) in the shoulder area. We use cookies and other tools to enhance your experience on our website and For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. collected, please refer to our Privacy Policy. The decelerated rehabilitation avoids excessive tension on the SS & IS by avoiding excessive scaption, ER, & FF until 4 weeks. Day 1 - 3 weeks. . Rehabilitation after Rotator Cuff Repair. to analyze our web traffic. 2 0 obj Dr. O'Holleran is Fellow, Harvard Shoulder . QlR#D' Nikolaidou O, M. S. (2017). The skin over your surgical site will be cleaned with an antiseptic solution. There may be other risks depending on your specific medical condition. Rotator cuff degeneration and tears may also be caused by aging. About Us; Meet Our Team; Our Services; Nerves or blood vessels in the area of surgery may be injured. If your rotator cuff is injured, you may need to repair it surgically. endobj It consists of a system of lenses, a small video camera, and a light for viewing. In older patients, there may not be an injury or event to cause the tear. The arthroscope is often used in conjunction with other tools that are inserted through another incision. You may undergo blood tests or other diagnostic tests. }@o~+msq8JJ|vd24a2e> BRIGHAM AND WOMEN'S HOSPITAL. collected, please refer to our Privacy Policy. biceps tenodesis procedure involves cutting of the long head of the biceps just prior to its insertion on the superior labrum and then anchoring the tendon along its anatomical course more distally along the humerus. Rotator cuff repair may be done while you're asleep under general anesthesia or while you're awake under local or regional anesthesia. Your provider will arrange for an exercise rehabilitation program to help you regain muscle strength, flexibility, and function of your shoulder. Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. 617-732-5500, New Patients: You may resume your normal diet unless your provider advises you differently. You will eventually be prescribed strengthening exercises. 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. The information contained in these standards of care or protocols is not intended in any way to be used as primary medical advice or to replace medical advice offered by physical, occupational, speech therapists or other health care professionals. to analyze our web traffic. You should keep the sling or immobilizer on as directed by your provider. Rotator cuff surgery may be performed using an arthroscope. This rehabilitation protocol has been developed for the patient following a large to massive rotator cuff surgical procedure. Mass General - Boston Read the form carefully and ask questions if something isn't clear. Microsoft Word - Rotator cuff and SLAP patient info.doc If you believe you should have an evaluation and would like to schedule an appointment with one of our orthopaedic surgeons for rotator cuff surgery, knee replacement surgery or hip replacement surgery, call 1-800-294-9999 to speak to one of our knowledgeable coordinators who can help to connect you to the doctor that best meets your needs, or fill out an online appointment request form. These treatments may include: rest, activity modification, non-steroidal anti-inflammatory medication and physical therapy. 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. Rotator Cuff Repair Rehab Protocol-Brigham and Women's Hospital. x][~G[" $`u[6=nwgz~HH[6M} ^|jg4?/>=W6ugqAxi??='O71R +gA^V%w?h0J6 }l?x)?VQ,QK-XTS1aM Shoulder Precautions 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. In the case of a delayed therapy start, the following timeframes are to be adjusted so that day 1 is the first day of therapy. LL`}*Tg/#VA|5RQSVt*#bH|5 [oB]bPY) 1ULXv$6*jthb Ylv 4 0 obj 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. The rotator cuff keeps the shoulder in the socket. 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. This may include shaving off bone spurs that are pinching the shoulder, and repairing torn tendons or muscles in the shoulder. NEW HARTFORD. smoking, hypercholesterolemia and diabetes. You may get a medicine (sedative) before the procedure to help you relax. endstream endobj 770 0 obj<>stream The following Protocols are the property of Brigham and Women's Hospital (BWH) and are linked here with permission. ntr>&TZt`3o6?=^_.9|0dd\H c9{+'+::A{NhV{. The camera is connected to a monitoring system that allows the doctor to view a joint through a very small incision. Injuries to the shoulder are common. The rotator cuff is made up of muscles and tendons that hold the shoulder in place. % For more information, please visit the following webpages on orthoinfo.org: Please visit orthoinfo.org if your condition is not listed above. Medical treatments for rotator cuff injury may include the following: Nonsteroidal anti-inflammatory drugs (NSAIDs). These muscles originate on the shoulder blade and attach to the humeral head. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. 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. Always follow your healthcare professional's instructions. %PDF-1.7 <> In some cases, a tendon graft and joint replacement may be necessary. The presence of a RCT can cause a vast array of impairments and associated dysfunctions. Journal of Shoulder and Elbow Surgery, 4:521-535. Generally, rotator cuff repair surgery follows this process: You'll be asked to remove clothing and given a gown to wear. stream Search for condition information or for a specific treatment program. To help reduce swelling, you may be asked to apply an ice bag to the shoulder several times per day for the first few days. For very large tears, physical therapy may be delayed to promote rotator cuff healing up to 6 weeks postoperatively. 1 Oxford Road New Hartford, NY 13413. Mass General Brigham's Sports Medicine Program now offers urgent access virtual visits. In addition to a complete medical history, your provider may do a complete physical exam to make sure that you're in good health before undergoing the procedure. We use a comprehensive approach to caring for the whole athlete, treating your sports injury and helping you return to the activities you love. @O]2QCl*x[c@V(.G?L(#? You may be given an immobilizer or sling before you go home. Start progressive rotator cuff and shoulder strengthening at 3 months - isometrics initially Initiate isotonic strengthening at 4 months (Theraband, dumbbells, Hughston's exercises, etc). 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. 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. 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. Operative report should be read to determine the extent of rotator cuff involvement, integrity of the articular surface, involvement of the biceps tendon and glenoid labrum. Other incisions may be made to use other small grasping, probing, or cutting tools. Stay Informed. Control pain and swelling Activities: 1. Athletes and construction workers often have rotator cuff injuries due to repetitive movement and overuse of the shoulder. Shoulder injuries are common. Comprehensive and innovative bone and joint care is the foundation of the Center, beginning nearly a century ago when one of our founding hospitals, the Robert Breck Brigham Hospital, became the first teaching hospital in the country wholly devoted to arthritis treatment and related diseases. Tell your provider about all prescription and over-the-counter medicines and herbal supplements that you're taking. endobj 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. 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. <>/Metadata 1084 0 R/ViewerPreferences 1085 0 R>> 85 College Street Hamilton, NY 13346. The stitches or surgical staples will be removed during a follow-up office visit. You can ask questions. Boston, Learn about Real Therapy Standards of Care and Protocols since that Rehabilitation Services at Brightam additionally Women's Infirmary. repair, other BEAR procedure, real ACL reconstructing in pre- chronic models.21,33 . Rotator cuff surgery may be done using an arthroscope. Tell your provider if you're sensitive to or allergic to any medicines, latex, tape, and anesthetic agents (local and general). Avoid excessive reaching and external/internal rotation for the first 6 weeks. Women's Orthopedic and Joint Disease Center, Anesthesiology, Perioperative and Pain Medicine. Follow any directions you're given about not eating or drinking before your procedure. The incision will be closed with stitches or surgical staples. All rights reserved. We use cookies and other tools to enhance your experience on our website and Brigham and Women's Hospital, Boston. The rotator cuff consists of four muscles that come together as tendons to cover the head of the humerus. Your recovery process will vary depending on the type of anesthesia that is given and the type of surgery thats done. endobj The incision will vary depending on the type of surgery (open surgery, arthroscopy, or a combination of both) that may be done. <>/ExtGState<>/XObject<>/ProcSet[/PDF/Text/ImageB/ImageC/ImageI] >>/MediaBox[ 0 0 612 792] /Contents 4 0 R/Group<>/Tabs/S/StructParents 0>> The rotator cuff is a slow healing structure due to poor blood supply. 833 0 obj <>/OCGs[835 0 R 836 0 R]>>/StructTreeRoot 164 0 R/Type/Catalog>> endobj 98 0 obj <> endobj 2783 0 obj <>stream 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. General Information: Mass General Brigham's network of Harvard Medical School-affiliated experts leads the nation in sports medicine research, technology, and innovations. 2023 ROM Exercises; Maximise shoulder strength of deltoid, intact cuff muscles and scapula stabilisers. For over a century, a leader in patient care, medical education and research, with expertise in virtually every specialty of medicine and surgery. Arthroscopic Rotator Cuff Repair Frequently Asked Questions: If you're pregnant or think that you could be pregnant, tell your provider. Be sure to take only recommended medicines. This evidence-based small to medium rotator cuff repair physical therapy guideline is criterion-based; time frames and visits in each phase will vary depending on many factors, including patient demographics, goals, and individual progress. Using sutures and suture anchors, the torn muscle and tendon are sewn back to the bone where it was originally attached. Abstract. Surgical techniques that may be used to repair a tear of the rotator cuff include arthroscopy, open surgery, or a combination of both. {QHCr!3g6jE6YQ` Rehab Plans and Exercises Minor Rotator Cuff Repair Protocol for Physiotherapy Following Surgery. Rotator Cuff Repair. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand or develop over time due to repetitive activities. ns6K2*\2 9LSs. Quick Links. Bone spurs will be removed if there are any. The arthroscope (if used) will be put through the incision. Expect full recovery to take up to 4 to 6 months. This usually involves reattaching the tendon to the head of the humerus. Learn about the many ways you can get involved and support Mass General. collected, please refer to our Privacy Policy. 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. endobj Ensure wound healing 3. General Information: A surgical repair is indicated when pain 1 Chung SW et al. For more information about these cookies and the data They should not be copied or otherwise used without the permission of the Director of Rehabilitation Services. A surgical repair is indicated when pain cannot be managed with conservative methods and is associated with weakness that causes a significant loss of function. Call 617-643-3333 if youre experiencing a sports injury. Include home cuff strengthening program. An IV (intravenous) line may be started in your arm or hand. 1 0 obj 2 0 obj The type of anesthesia will depend on the specific procedure being done. You may not recover full range of motion in the shoulder joint. You'll be asked to sign a consent form that gives your permission to do the procedure. x=n8zE$ The Sports Physical Therapy Service is an integral part of the Sports Medicine Center and the Department of Physical and Occupational Therapy. It consists of a system of lenses, a small video camera, and a light for viewing. %gN+K(( 8VC|[WN#( Y2,,-_:,=t6h(#9 Reverse or inverse total shoulder arthroplasty (rTSA) is becoming a widely accepted surgical intervention.
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