A session with the physiotherapy team
A question and answer session with the physiotherapy team at St Andrew's War Memorial Hospital, covering reverse total shoulder replacement and the use of Blueprint planning software in preparing for surgery.
What a reverse total shoulder replacement is
The shoulder is a ball and socket joint, with the ball on the top of the arm bone and a shallow socket on the shoulder blade. In a reverse replacement that arrangement is turned around, so that a ball is fixed to the shoulder blade and a socket to the arm bone. The reason for doing so is mechanical: the reversed design moves the centre of rotation and lengthens the line along which the deltoid works, which allows the deltoid to raise the arm on its own. That makes the operation suitable for shoulders in which the rotator cuff tendons are torn beyond repair, and for arthritis occurring alongside cuff damage. Individual results vary.
Why planning is relevant to physiotherapists
Pre-operative planning software uses the patient's CT scan to work out the size and position of the implant components before the operation. That matters to the physiotherapy team because the position of the components influences how the shoulder moves afterwards, and therefore what is realistic to aim for in rehabilitation.
A physiotherapist who understands what was planned and why is better placed to set expectations with the patient and to recognise when progress is or is not following the expected course. Movement gained after this operation depends on the planning, the surgery and the rehabilitation together, not on any one of them.
Why sessions like this are held
Patients spend far more time with their physiotherapist after a shoulder replacement than with their surgeon, so a shared understanding of the operation is practical rather than academic. A question and answer format works better than a lecture here, because the questions that come from a team doing the rehabilitation are the ones that arise repeatedly in practice.
With thanks
Thank you to the physiotherapy team at St Andrew's War Memorial Hospital for the questions and the discussion.
Related information
- Our reverse total shoulder replacement page
- Our rehabilitation page
- Our shoulder arthritis page