Total Shoulder Arthroplasty: Why Functional Neglect is Minimizing Outcomes
Total Shoulder Arthroplasty (TSA) and Reverse Total Shoulder Arthroplasty (R TSA) have increased by 243% in the last decade and will steadily climb with the emergence of the baby boomer generation. In addition, over 1/3 of all TSA and R TSA patients are under the age of 64. As quantitative outcomes have steadily increased with the advancement of surgical techniques, therapy protocols for the TSA patient have emphasized range of motion and strength while neglecting function, neuromuscular re-education, and proprioception. This lecture will discuss the techniques used by surgeons to access the shoulder, common prosthesis used for TSA and R TSA, and a “gold standard” 3 phase protocol. We will review how even the “best” protocols typically don’t emphasize a personalized approach and limit functional based intervention. We will also study the emergence of younger patients electing for total shoulder arthroplasty and their ability to return to normal activity including sports. Finally, we will learn the need for function-based intervention and the role of therapy to maximize results following TSA.
- Identify the current trends and projections regarding total shoulder arthroplasty and reverse total shoulder arthroplasty.
- Identify current components, surgical procedures, and functional treatment strategies for the TSA client based on current evidence and research.
- Identify the vital role of therapy in maximizing functional outcomes and proprioception following TSA.
- Identify documentation strategies and language for the TSA client based on information provided in this course to justify therapy services to all payer sources.
- 8:00 – Common Themes and research behind Total Shoulder, Reverse Shoulder, and Hemiarthroplasty
- 8:10 – “Functional Outcomes”: how they are measured, and what is wrong with the current measure of outcomes
- 8:30 – Total Shoulder Arthroplasty: procedures and components (RSA vs TSA and Subscap Sparing)
- 8:50 – How Therapy can be the difference with TSA outcomes (function vs. ROM, education, hospital readmission)
- 9:20 – Documentation: ideas and strategies outside the box
- 9:30 – Q/A and Adjourn
- Trent Brown, MOT, OTR/L, BCG
Trent Brown, MOT, OTR/L, BCG, is a practicing therapist in Utah and is 1 of 24 credential holders of a board certification in gerontology (BCG) from the AOTA. Trent has worked in transitional rehab, acute care, skilled nursing, and home health over the course of his career. His master’s thesis, “Performance of ADL’s, functional activity, mobility, and confidence levels following total hip arthroplasty”, was the launching pad for his future clinical focus and passion. Trent has centered his practice on research, exercise, and activity to promote safety and outcomes during functional mobility and activity with adult and geriatric populations.
Trent served as vice president of the Utah Occupational Therapy Association (UOTA), where he helped co-author the new Utah Occupational Therapy Practice Act. He has received APTA approval as a certified continuing education presenter, teaches at the University of Utah as an adjunct professor and was recently the requested keynote speaker at the annual UOTA conference. Additionally, he has provided continuing education courses for thousands of clinicians throughout the country. His lectures incorporate hands-on demonstration on a myriad of topics, including joint arthroplasty, core strengthening, documentation, aging, and fall reduction.
Contact Hours: 1.5