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Faculty of Medicine, University of Geneva, Geneva, Switzerland
Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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macro-instability (defined as a recurrent shoulder dislocation), they seem inefficient in preventing micro-instability (defined as residual humeral head translation), which could be an explanation for persistent apprehension. 77 Rehabilitation
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shoulder instability into two groups with the abbreviations TUBS (traumatic, unilateral, Bankart lesion and surgery) and AMBRI (atraumatic, multidirectional, bilateral, rehabilitation, inferior capsular shift) ( 5 ). However, since distinctions between
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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bodyweight have been reported during shoulder rehabilitation. 6 Humeral head Proximal humerus anatomy is subject to great variability, which is further significantly modified by arthritic changes. 7 , 8 As ATSA can restore physiologic shoulder kinetics
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arthroscope in the posterior portal and the arm in a neutral position, the arm is then externally rotated to assess the stability of the repair. If the forearm externally rotates past 50 degrees, this is noted for the post-operative rehabilitation limits. The
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both as a conservative treatment modality and during postoperative rehabilitation. The goal of conservative treatment is to improve the ROM, whereas postoperative rehabilitation is used to maintain the achieved ROM during surgery. Best results of
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Division of Orthopaedics and Trauma Surgery, Department of Surgery, Geneva University Hospitals, Geneva, Switzerland
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The initial reverse shoulder arthroplasty (RSA), designed by Paul Grammont, was intended to treat rotator cuff tear arthropathy in elderly patients. In the early experience, high complication rates (up to 24%) and revision rates (up to 50%) were reported.
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The most common complications reported were scapular notching, whereas clinically more relevant complications such as instability and acromial fractures were less commonly described.
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Zumstein et al defined a ‘complication’ following RSA as any intraoperative or postoperative event that was likely to have a negative influence on the patient’s final outcome.
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High rates of complications related to the Grammont RSA design led to development of non-Grammont designs, with 135 or 145 degrees of humeral inclination, multiple options for glenosphere size and eccentricity, improved baseplate fixation which facilitated glenoid-sided lateralization, and the option of humeral-sided lateralization.
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Improved implant characteristics combined with surgeon experience led to a dramatic fall in the majority of complications. However, we still lack a suitable solution for several complications, such as acromial stress fracture.
Cite this article: EFORT Open Rev 2021;6:1097-1108. DOI: 10.1302/2058-5241.6.210039
These authors contributed equally to the article and should all be considered first authors
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the coupling activity of the serratus anterior and lower trapezius muscles. If this manoeuvre leads to improved range of motion or pain reduction, it is considered positive, and the patient can benefit from the rehabilitation of the scapular
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Chirurgie de l’Épaule, Service d’Orthopédie et Traumatologie, Ensemble Hospitalier de la Côte, Morges, Switzerland
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five-session rehabilitation programme ( 2 ). Massive rotator cuff tear was defined as full-thickness tears of two or more tendons, stage 3 or 4 Goutallier fatty muscle degeneration and shoulder active forward elevation (AFE) pseudoparesis. The programme
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. Management Non-operative management Although non-operative treatment is commonly used, Rettig et al 28 reviewed a series of baseball players managed with rest and rehabilitation. Only 42% were able to return to sports activity at a mean time of six
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et al 26 found after a follow-up of 48 months that 14 of 15 patients had substantial improvement in active forward elevation to above 90°. The protocol of rehabilitation focuses habitually on a multimodal physiotherapy programme with global
