Successful Outcomes Achieved Via Web-based, Home Program after Total Shoulder Arthroplasty

Document Type : RESEARCH PAPER

Authors

The Rothman Institute at Thomas Jefferson University, Philadelphia, PA, USA

Abstract

Background: The primary goals of total shoulder arthroplasty (TSA) are to relieve pain, improve range of motion,
and restore function. Physical therapy is commonly used to help achieve these goals. Recent evidence has pointed
to the success and safety of a purely physician-guided, home-based or internet-based, program versus the traditional
therapist guided program.
The purpose of this study was to evaluate outcomes of TSA in patients using a web-based, home therapy program.
Methods: A retrospective review was performed of TSA patients who were given the option of using a web-based,
home therapy program. Functional outcomes were collected preoperatively, 6-month, and 12-month post-operative
examinations. Physical examination parameters were recorded at preoperative, 3-month, 6-month, and 12-month timepoints.
Results: Forty-seven patients used the web-based, home therapy program and had complete follow-up data at all
time intervals. All mean range of motion parameters and functional scores improved significantly from preoperatively to
postoperatively. There was one reported complication in a patient who sustained a subscapularis rupture and underwent
subsequent open repair at 10 months postoperatively.
Conclusion: This study demonstrates successful improvements in range of motion and functional outcomes in a
subset of patients who utilized an online therapy program after TSA. Future study will be necessary to directly compare
results in patients enrolled in formal, outpatient therapy programs and to determine barriers to utilization of web-based
therapy programs.
Level of evidence: IV

Keywords

References

1. Deshmukh AV, Koris M, Zurakowski D, Thornhill TS.
Total shoulder arthroplasty: long-term survivorship,
functional outcome, and quality of life. Journal of
shoulder and elbow surgery. 2005; 14(5):471-9.
2. Chin PY, Sperling JW, Cofield RH, Schleck C.
Complications of total shoulder arthroplasty: are they
fewer or different? Journal of shoulder and elbow
surgery. 2006; 15(1):19-22.
3. Carter MJ, Mikuls TR, Nayak S, Fehringer EV, Michaud
K. Impact of total shoulder arthroplasty on generic
and shoulder-specific health-related quality-of-life
measures: a systematic literature review and metaanalysis.
JBJS. 2012; 94(17):e127.
4. Austin MS, Urbani BT, Fleischman AN, Fernando ND,
Purtill JJ, Hozack WJ, et al. Formal physical therapy after
total hip arthroplasty is not required: a randomized
controlled trial. JBJS. 2017; 99(8):648-55.
5. Day JS, Lau E, Ong KL, Williams GR, Ramsey ML, Kurtz
SM. Prevalence and projections of total shoulder
and elbow arthroplasty in the United States to
2015. Journal of shoulder and elbow surgery. 2010;
19(8):1115-20.
6. Brems JJ. Rehabilitation following total shoulder
arthroplasty. Clinical orthopaedics and related
research. 1994 (307):70-85.
7. Bruzga B, Speer K. Challenges of rehabilitation after
shoulder surgery. Clinics in sports medicine. 1999;
18(4):769-93.
8. Denard PJ, Lädermann A. Immediate versus delayed
passive range of motion following total shoulder
arthroplasty. Journal of shoulder and elbow surgery.
2016; 25(12):1918-24.
9. Mulieri PJ, Holcomb JO, Dunning P, Pliner M, Bogle
RK, Pupello D, et al. Is a formal physical therapy
program necessary after total shoulder arthroplasty
for osteoarthritis? Journal of shoulder and elbow
surgery. 2010; 19(4):570-9.
10. Mahomed NN, Davis AM, Hawker G, Badley E, Davey JR,
Syed KA, et al. Inpatient compared with home-based
rehabilitation following primary unilateral total hip
or knee replacement: a randomized controlled trial.
JBJS. 2008; 90(8):1673-80.
11. Moffet H, Tousignant M, Nadeau S, Mérette C, Boissy
P, Corriveau H, et al. In-home telerehabilitation
compared with face-to-face rehabilitation after total
knee arthroplasty: a noninferiority randomized
controlled trial. JBJS. 2015; 97(14):1129-41.
12. Russell TG, Buttrum P, Wootton R, Jull GA. Internetbased
outpatient telerehabilitation for patients
following total knee arthroplasty: a randomized
controlled trial. JBJS. 2011; 93(2):113-20.
13. Barinaga G, Chambers MC, El-Othmani MM, Siegrist
RB, Saleh KJ. Affordable care organizations and
bundled pricing: a new philosophy of care. Orthopedic
Clinics. 2016; 47(4):707-16.
The Archives of Bone and Joint Surgery
Volume 8, Issue 6
November and December 2020
Pages 61-667

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History

  • Receive Date: 18 September 2019
  • Revise Date: 15 February 2020
  • Accept Date: 01 March 2020

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