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TSA - July 9, 2004 6:10:00 AM
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CarolinaPT
Posts: 20
Joined: May 6, 2004
From: North Carolina
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Just wondering what everyone's expectations are with a total shoulder replacement? I have a 65 yo m who is one of the hardest working patients that I have had and he keeps asking if he will ever be 100%. I tell him that the anatomy has changed and so 100% may be high, but I wanted to know what kind of results others are getting with their patients and what they expect.
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Re: TSA - July 9, 2004 6:49:00 AM
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ericdmb
Posts: 14
Joined: May 1, 2003
From: East Falmouth
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Depends on a lot of factors, how much of his cuff is intact, if the tissue quality of the remaining cuff is really poor his funcitonal outcome may not be all that great, but pain relief should be good, now if the tissue quality was good and the surgeon did a good job of re-attaching subscap and repairing any other cuff damage, outcome could be close to 100%, I've seen TSAs play tennis, throw a ball so it is certainly possible, though does not occur frequently.
_____________________________
Eric D. Wheeler,
MSPT, MPE, CSCS
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Re: TSA - July 9, 2004 10:29:00 AM
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USAPT
Posts: 278
Joined: January 14, 2004
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I treated a pt. w/ a total shoulder and he was eventually able to return to golf, though not at 100%, and perform as much of his normal ADLs. As Eric stated, this is not typical. Also when he went for a f/u to MD, the MD ran out of the room to grab all the residents as he could not believe pts. outcome...made my day to hear that!! Hard working is great but you also have to consider pts. med. hx and previous functional status. I can't honestly give you a % as I have only treated that 1 pt. Good luck
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Jason, PT
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Re: TSA - July 9, 2004 10:40:00 AM
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CarolinaPT
Posts: 20
Joined: May 6, 2004
From: North Carolina
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Well, this patient is already back to playing golf, can throw without pain, but wants to get back to playing tennis. He went out the other day and had some minimal soreness after hitting some tennis balls, but overall is doing well. THe patient is not happy though unless he is able to do everything and has full range of motion with the shoulder (currently at about 90%). I try to tell him that his outcome is excellent, but he just wants more.
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Re: TSA - July 9, 2004 12:21:00 PM
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USAPT
Posts: 278
Joined: January 14, 2004
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It's not going to be perfect. He should be greatful that he can do the things he can, as we all know even RC pts. sometimes don't even get that functional! Tell him to play underhand and enjoy the rest of his life
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Jason, PT
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Re: TSA - July 9, 2004 1:07:00 PM
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ericdmb
Posts: 14
Joined: May 1, 2003
From: East Falmouth
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that's a great outcome, he should be happy ! just curious, why did he have the surgery ? DJD, pain, fracture
_____________________________
Eric D. Wheeler,
MSPT, MPE, CSCS
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Re: TSA - July 9, 2004 7:09:00 PM
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CarolinaPT
Posts: 20
Joined: May 6, 2004
From: North Carolina
Status: offline
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Eric- he had his TSA 2 DJD.
USAPT- do you think it is totally unrealistic for him to be able to serve overhand? His MD has cleared him for all movements, including AB with ER, so I have been progressing him towards serving, but actually, this is what is giving me the most trouble and it is what he wants to be able to do. The difficult thing is like you say, most TSAs do not progress this far or this well, so to some extent I am in uncharted territory trying to predict further outcomes.
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