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Review Question - QID 6611

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QID 6611 (Type "6611" in App Search)
A 69-year-old woman has just undergone an uncomplicated total shoulder arthroplasty for glenohumeral osteoarthritis. A press-fit humeral stem and a cemented all-polyethylene glenoid component were placed. At this point, what is the postoperative rehabilitation plan?

Maintain sling immobilization for 6 weeks, and then begin a global range-of-motion program.

0%

0/7

Maintain sling immobilization for 3 weeks, and then begin a global range-of-motion program.

29%

2/7

Immediately begin an active assisted range-of-motion program emphasizing forward elevation and external rotation to the side.

29%

2/7

Immediately begin a passive range-of-motion program for forward elevation only; no external rotation is allowed for 6 weeks.

29%

2/7

Immediately begin active range of motion in forward elevation and external rotation to the side with a progression to full rotator cuff strengthening in 3 weeks.

14%

1/7

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The patient needs to immediately begin an active assisted range-of-motion program emphasizing forward elevation and external rotation to the side. Sling immobilization without stretching for either 3 or 6 weeks will result in severe stiffness that will compromise her ultimate range of motion. Since she has a good quality subscapularis tendon, there is no need to avoid beginning external rotation to the side. However, starting a strengthening program at 3 weeks risks tearing the subscapularis tendon repair. Active strengthening should not begin for 6 weeks postoperatively to allow the subscapularis tendon repair time to heal.

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