POST OP Flashcards
T or F: surgery restarts the connective healing model
True
if you get a post op patient, make sure to get…
OP REPORT!
get great history and good exam
what kind of range of motion are we looking at post op?
PROM (not necessarily full range)
order of fastest rehab/PT:
rTSA
large rotator cuff repair
bankart
- rTSA (3-4 months)
- bankart (4-6 months)
- cuff (6-7 months)
(order from LAB)
BUT formal PT 6-9 months for bankart if they need high capability (sports) –> (order from LECTURE)
early rTSA: what are we most afraid of? Precautions?
DISLOCATION
no AROM/AAROM
no PROM IR
(no lifting, no CKC, no behind back, no shoulder extension)
when can you initiate AAROM/AROM for rTSA
weeks 4-6 (phase 2)
when can you initiate shoulder PROM IR in scapular plane for rTSA
phase 3 (7-8 weeks)
What can you never ever do for the rest of your life with a rTSA
:(
no lifting more than 15 lbs
no CKC with full WB (push ups, planks)
what mm is most important to strengthen in rTSA
deltoid
what are we most afraid of with a large rotator cuff repair
RE TEAR (no active for 12 weeks)
what are phase 1 and 2 precautions for large rotator cuff repair
no AROM
starting week 6-10: do PROM but avoid past 90 flex, abd, 30 ER and NO IR PROM
no CKC!
large rotator cuff repair
phase 3 (10-14 weeks) and phase 4 (14-18 weeks) looks like
AAROM –> AROM
can start isometrics 14-18 weeks
*start with flex and abduction, add in ER/IR AROM weeks 12-14
what does phase 5 (22-26 weeks) look like for large rotator cuff repair
- after week 22, can do more aggressive stretching of shoulder
- no lifting > 10 lbs
- no overhead lifitng
- no sudden pushing or lifting
- no painful activity
last phase of large rotator cuff repair: return to sport
(weeks 26-30) will look like
start plyometrics
goal of 85-90% shoulder strength of other side with HHD
precautions:
no heavy/forceful lifting, sudden stuff, no painful activity
Bankhart repair: what are we most afraid of
dislocation or healing loose
dislodging anchors
FRESH POST OP: NO SHOULDER ROTATION, NO LIFTING, NO FULL WB CKC
phase 1 and 2 (0-3, 4-6 weeks) of bankart repair should look like
- PROM up to 90 flex, 90 abd, 30 ER, edema control
- no AROM, no lifting, no CKC BW
weeks 4-6: wean off sling
When can you start rotator cuff strengthening with bankhart repair?
phase 3 (weeks 7-8)
still no lifting > 10 lbs
When is a good time to do CKC stuff for posterior rotator cuff activation with bankhart repair?
phase 5: 12-16 weeks
when should you do functional and return to work/sport stuff for bankhart repair?
last phase: phase 7: early return to sport
4-6 months
What is a latarjet
fixing the glenoid/labrum (dislocated shoulder so much you lose bone)
attach coracoid to where the anterior glenoid/labrum should be with screws
What is a high tibial osteotomy
remove slice of proximal tibia to fix knee alignment (treat like a fracture you paid for)
What is a xenograft augmentation?
using an animal graft to patch torn tendon
*bc their own tissue is damaged, maybe bc of less Blood supply or a systemic condition
What is a Bankhart repair
anterior labrum anchored to glenoid: 3-6 o clock
(bc of dislocation)
like a
beast
