Reverse Shoulder Replacement: Formal vs. Home Physiotherapy

All patients who are evaluated by one of three Shoulder/Elbow Fellowship-trained surgeons at Washington University Department of Orthopedic Surgery and who meet the inclusion criteria will be offered enrollment in the study. Following consent the participant will be asked to undergo an exam of the shoulder and complete questionnaires related to shoulder pain and function.

Demographic information, health history related to the affected shoulder, and co-morbidity data will also be collected preoperatively.

Patients will be randomized to either a simple, standardized home exercise program or a supervised physiotherapy program administered by a physical therapist after undergoing a standardized operative protocol for reverse total shoulder arthroplasty.

Post-operative range of motion will be measured in a blinded fashion at 6 weeks, 3 months, 6 months, and 12 months. A blinded observer will simultaneously measure validated functional outcomes scores including the Western Ontario Osteoarthritis Score, American Shoulder and Elbow Surgeons Score and Visual Analogue Score for pain pre-operatively and at 6 weeks, 3 months, 6 months, and 12 months post-operatively.

Inclusion criteria

• Primary RTSA for the diagnosis of rotator cuff tear arthropathy (RCTA) or irreparable rotator cuff tear.
• A pre-operative plan for RTSA
• Age >60

Exclusion criteria

• Active infection
• Incompetent deltoid muscle
• Unwillingness or inability to participate in a home exercise program
• Medically unfit for operative intervention
• Revision RTSA
• RTSA for glenohumeral osteoarthritis or proximal humerus fracture
• Unwillingness to participate in the study
• Inability to read or comprehend written instructions