The position of the resection guide boom on the reamer shaft, along with the calibrated reaming depth and stem choice, are directly related. If using the micro stem, specialorder micro broaches are required. Comprehensive total shoulder system surgical technique. Pdf the open shoulder model is the only opensim model with an independently controlled scapula that has a winging degree of freedom. Total shoulder replacement protocol sports and ortho. During a shoulder arthroscopy, a small video camera attached to a fiberoptic lens is inserted into the shoulder joint to allow a surgeon to see without making a large incision. This device is offered for sale by or on the order of. Successful agreement was achieved between the two methods, with an oxford shoulder score intraclass correlation icc of 0. Polyethylene compression fit also can be used with the comprehensive. The shoulder has the capacity to go through triplane loading as well as triplane unloading. Comprehensive reverse shoulder system superior approach this brochure is presented to demonstrate the surgical technique and postoperative care protocol utilized by david adkison, m. Utilize a modified beach chair position at about 3040 degrees of flexion. Jul 12, 2016 comprehensive reverse shoulder system. Rehabilitation following total shoulder arthroplasty reg b.
Magnetic resonance mr imaging evaluation of the painful failed shoulder arthroplasty is a useful imaging modality due to advancements in metal artifact reduction techniques, which allow assessment of the integrity of the supporting softtissue envelope and the implant. Standardmicro figure 10 standard, mini, and micro stem technique standard and micro technique figure 9. F rozen shoulder, also known as adhesive capsulitis, refers to a condition where the shoulder becomes painful and stiff. They can be a result of a traumatic injury such as a fall or motor vehicle accident, or from general wear and tear. The shoulder joint the shoulder joint is made of the humeral head and the glenoid. Comprehensive total shoulder system early clinical outcomes author. Magnetic resonance imaging of shoulder arthroplasty. A patients guide to frozen shoulder ways we treat your. Notes for figure 6h1typical application 1 work beyond.
Acromioclavicular joint in addition to history and physical exam, initial evaluation is always started with plain. It may follow an injury or arise gradually with no injury or warning. Elaine klappal, clinical research technical writer, biomet orthopedics, inc. Positions include gunslinger, neutral plane, and statue of liberty. It also offers the flexibility to move from a hemiarthroplasty to a total or reverse arthroplasty, or revise if necessary.
Regenerex porous titanium for biologic fixation application 2. Biomet as a manufacturer of this device does not practice medicine and does not recommend this device or technique. It may occur following a relatively minor injury to the shoulder but most often develops without a clear reason. The comprehensive total shoulder system is an evolutionary design based on the successful clinical heritage of the biomodular shoulder system. Allow involved arm to hang down, perpendicular to the floor. It is designed for use as a primary reverse prosthesis when there is grossly deficient rotator cuff, or to convert to a reverse from a wellfixed comprehensive primary, revision or fracture stem. The shoulder goes through loading by being stimulated by what happens at the scapula. Nonsurgical shoulder impingement rehabilitation protocol. All sessions are supervised by linda hallam assistant surgical practitioner, john barber simulations manager andor lennard funk surgeon. Shoulder arthroscopy the following are general guidelines that may vary depending on the individual, the details of the procedure, andor the anesthesia that was administered.
These options provide intraoperative flexibility, even in complex revision cases. The biomet comprehensive reverse total shoulder system. The effect of neuromuscular electrical stimulation of the. Nonsurgical rehabilitation for multidirectional shoulder. Frozen shoulder, or adhesive capsulitis, is a condition that begins with a gradual onset of pain and a limitation of shoulder motion. Biomet issued written notices on 172015, requested completion and submission of responseeffectiveness forms for product part number.
Can you place your hand behind your head with the elbow. Tendinitis which is an inflammation of the rotator cuff tendon. The comprehensive fracture, and revision and micro stems figure 22 are compatible with the comprehensive reverse shoulder. Hcp content posted july 12, 2016 in animated demonstrations and zimmer biomet extremities. The comprehensive reverse shoulder system was designed to provide a complete, seamless system based on the comprehensive shoulder platform. Frozen shoulder what can a physical therapist do for my painful and stiff shoulder.
Look for wasting or asymmetry of shoulder height, scapular position and muscle bulk observation of posture. Biomet comprehensive reverse shoulder products are indicated for. This was consistent across all investigated outcome scores, where the constant has an icc of 0. The comprehensive srs system is compatible with comprehensive shoulder. Gallandkirby total shoulder arthroplasty postsurgical rehabilitation protocol postop days 1 14 sling for comfort, dc after 45 days sleep with pillow under shoulder arm for comfort hand squeezing exercises elbow and wrist active motion arom pendulum exercises. The patient will attend the first available postoperative shoulder group usually friday following surgery for education, advice. Numbers are strictly limited to six people per session. Class 2 device recall comprehensive reverse shoulder.
Nonsurgical shoulder impingement rehabilitation protocol ramin r. Any patients exhibiting these symptoms will not be allowed to enter the clinic. Comprehensive nano humeral components increased risk of revision when used in reverse configuration mda2017023 published 18 august 2017. The joint capsule is in a sac that covers or surrounds the shoulder joint. Comprehensive reverse shoulder system zimmer biomet.
Comprehensive reverse shoulder system the comprehensive reverse shoulder builds on the foundation of the comprehensive shoulder system. Titanium glenospheres are intended for patients with cobalt alloy material sensitivity. The shoulder is a huge unit in reality with connections to the rib cage, sternum, clavicle, scapula, humerus, thoracic spine, lumbar spine, and into the rest of the body. Hawkinskennedy test the right humeral head is grasped with the right hand, while the left hand stabilizes the scapula. For the complete comprehensive fracture stem technique, please see boi0274. Page 634 2009 edition notes for figure 6h1typical application 1 work beyond the shoulder guidance. Biomet comprehensive reverse shoulder products are indicated for use in patients whose shoulder. It may occur following a relatively minor injury to the shoulder but most often develops without a. Today the shoulder is one of the joints in which the arthroscope is commonly used to both diagnose problems and to perform surgical procedures inside the joint.
Introduction shoulder joint replacement surgery also called shoulder arthroplasty is not as common as replacement surgeries for the knee or hip joints. Shoulder pain patients with shoulder pain can be generally divided into four groups. Comprehensive total shoulder system early clinical outcomes. A patients guide to frozen shoulder what is a frozen shoulder. Still, when necessary, this operation can effectively ease pain from shoulder arthritis. The arcos platform comprehensive solutions that simplify the complex. Shoulder evaluation a systematic approach before you act, think. The comprehensive total shoulder system features a broad array of options including wideranging sizes, customizable offset, potential for enhanced fixation and new, easytouse access glenoid instrumentation. Total shoulder joint replacement will be considered if other treatment. The use of nmes for the shoulder has received little attention in orthopaedic communities, with research limited to the rehabilitation of patients after cerebral vascular accidents. What is impingement how is impingement syndrome what. It is designed for use as a primary reverse prosthesis, or to convert to a reverse from a wellfxed comprehensive primary, revision or fracture stem. Kavanagh, pac this protocol provides general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of movement.
The comprehensive segmental revision system srs utilizes a multioption approach to address proximal, distal and total humeral replacement with the convenience of an allinclusive system. Rehabilitation following total shoulder arthroplasty. Millett, md, msc3 total shoulder arthroplasty tsa is a standard operative treatment for a variety of disorders of the. Over 1 million times per year, biomet helps one surgeon provide personalized care to one patient. Development of shoulder rehabilitation guidelines with icf classifications martin kelley pt, dpt, ocs john kuhn md phil mcclure pt, phd lori michener pt, phd, atc, scs mike shaffer pt, ocs, atc amee seitz pt, dpt, ocs tim uhl pt, phd, atc shoulder rehabilitation guidelines scope most common conditions limit to nonoperative care evidenced based. Westerhoff p, graichen f, bender a, halder a, beier a, rohlmann a, bergmann g in vivo measurement of shoulder joint loads during walking with crutches clin biomech bristol, avon. Comprehensive reverse shoulder system zimmer biomet tv. In functionally analyzing the shoulder, we want to focus on all three planes and at both ends of all three planes. Please call or text us at 505 7244300 with any questions update. The science and art of medical care is to provide the right. Total shoulder joint replacement will be considered if other treatment options will not relieve. Shoulder is placed in 90 of forward flexion and then forcibly internally rotating the shoulder. Comprehensive reverse shoulder system the comprehensive reverse shoulder system is the next generation reverse shoulder prosthesis, of the comprehensive reverse shoulder story the goal was simple. Whatever the cause of shoulder problems, the best cure is an accurate diagnosis from a physician specializing in the shoulder followed with appropriate care.
Whatever the type or cause of the arthritis, the shoulder may become painful and difficult to use. Based on the concept originally developed by grammont, the biomet comprehensive rsa utilizes initial design of the reverse ballandsocket implant while adding some newly developed technologic changes in order to avoid specific complications such as scapular. Comprehensive total shoulder system figure 4 standard, mini, and micro stem technique figure 5 figure 6 humeral preparation using the 4, 5 or 6 mm starter reamer and ratcheting thandle, bore a pilot hole through the humeral head along the axis of the humeral shaft, just lateral to the heads articular surface and just medial to the rotator. Whatever the cause of shoulder problems, the best cure is an accurate diagnosis from a physician specializing in the. A patient s guide to artificial joint replacement of the shoulder. Its the scapula in motion at the same time as the humerus is in motion that. Westerhoff p, graichen f, bender a, halder a, beier a, rohlmann a, bergmann g in vivo measurement of shoulder joint loads during activities of daily living journal of biomechanics 42, 18401849, 2009. Can you reach the small of your back to tuck in your shirt with your hand.
If the work space is in the median of a divided highway, an advance warning sign should also be placed. Systemic diseases, such as rheumatoid arthritis, may affect any joint in the body. The acromion is the outer tip of the scapula the shoulder blade. Control pain and edema normal rom, proprioception, strength. In normal shoulders, the joint capsule has some looseness which allows the shoulder to have full range of motion. We are requiring all patients exhibiting fever, cough, andor shortness of breath to reschedule their appointment. Validation of the delft shoulder and elbow model using invivo glenohumeral joint contact forces journal of biomechanics 43, 30073014, 2010. Frozen shoulder academy of orthopaedic physical therapy. Latarjet protocol the intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone a latarjet procedure for anterior stabilization.
Comprehensive total shoulder system figure 9 place the im resection guide block onto the arm of the boom in the proper orientation. Pendulum exercises bend forward at the waist, back parallel to ground is ideal. The comprehensive nano shoulder is compatible with all configurations of the comprehensive shoulder system, and is the first stemless device to provide surgeons with intraoperative flexibility to easily convert from a comprehensive nano hemiarthroplasty to a reverse or total shoulder arthroplasty using the same core instruments and without. Comprehensive total shoulder system hip knee shoulder. The right hand then loads the joint to ensure concentric reduction, and then applies anterior and posterior shearing forces. Kavanagh, pac this protocol provides general guidelines for initial stage and progression of rehabilitation according to specified time frames, related tissue tolerance and directional preference of. What is impingement how is impingement syndrome what causes. Diet postoperative nausea and vomiting is a common sideeffect of anesthesia. A patient s guide to artificial joint replacement of the. Although the first shoulder arthroplasty was implanted in 1893 by the french surgeon julesemile pean,11 the development of the procedure came in the 1950s when neer22 described the. Remove the drill from the pin, leaving the pin in place. Examination of the shoulder complex diagnosing the problem by reading the signs and symptoms examination of the patient with shoulder pain a observation from behind. Arthroscopic posterior stabilisation consideration should always be given to the individual patients ability.
For example, right should be visible for a right shoulder. Osteoarthritis is not the only type of arthritis that affects the shoulder joint. The comprehensive reverse shoulder is indicated for primary, fracture, or revision total shoulder replacement for the relief of pain and significant disability due to gross rotator cuff deficiency. The humeral head rests on the glenoid like a golf ball on a tee. It is no means intended to be a substitute for ones clinical decision making. This condition occurs when the rotator cuff tendon rubs impinges on the undersurface of the acromion bone and clavicle bone when the arm is raised overhead. It also makes conversion of an anatomic shoulder arthroplasty or fracture hemiarthroplasty ha to rsa much easier. Is your shoulder comfortable with your arm at rest by your side. Due to advancements in metal artifact reduction techniques, magnetic resonance mr imaging of the painful failed shoulder arthroplasty is a useful imaging technique to assess the integrity of the supporting softtissue sleeve and the implant, with the ability to provide information not otherwise afforded by other imaging modalities.
Longterm fixation small, medium and large glenoid bases three outer pegs for cemented fixation two central peg options 1. This device is offered for sale by or on the order of a physician or other qualified medical professional. A patients guide to artificial joint replacement of the shoulder compliments of. Utilizing innovative technologies, the system is able to allow for surgeon efficiency through.
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