Clinics in Shoulder and Elbow最新文献

{"title":"Online resources for information on shoulder arthroplasty: an assessment of quality and readability.","authors":"Mohamad Y Fares,&nbsp;Jaspal Singh,&nbsp;Amar S Vadhera,&nbsp;Jonathan Koa,&nbsp;Peter Boufadel,&nbsp;Joseph A Abboud","doi":"10.5397/cise.2023.00290","DOIUrl":"https://doi.org/10.5397/cise.2023.00290","url":null,"abstract":"<p><strong>Background: </strong>Many patients use online resources to educate themselves on surgical procedures and make well-informed healthcare decisions. The aim of our study was to evaluate the quality and readability of online resources exploring shoulder arthroplasty.</p><p><strong>Methods: </strong>An internet search pertaining to shoulder arthroplasty (partial, anatomic, and reverse) was conducted using the three most popular online search engines. The top 25 results generated from each term in each search engine were included. Webpages were excluded if they were duplicates, advertised by search engines, subpages of other pages, required payments or subscription, or were irrelevant to our scope. Webpages were classified into different source categories. Quality of information was assessed by HONcode certification, Journal of the American Medical Association (JAMA) criteria, and DISCERN benchmark criteria. Webpage readability was assessed using the Flesch reading ease score (FRES).</p><p><strong>Results: </strong>Our final dataset included 125 web pages. Academic sources were the most common with 45 web pages (36.0%) followed by physician/private practice with 39 web pages (31.2%). The mean JAMA and DISCERN scores for all web pages were 1.96±1.31 and 51.4±10.7, respectively. The total mean FRES score was 44.0±11.0. Only nine web pages (7.2%) were HONcode certified. Websites specified for healthcare professionals had the highest JAMA and DISCERN scores with means of 2.92±0.90 and 57.96±8.91, respectively (P<0.001). HONcode-certified webpages had higher quality and readability scores than other web pages.</p><p><strong>Conclusions: </strong>Web-based patient resources for shoulder arthroplasty information did not show high-quality scores and easy readability. When presenting medical information, sources should maintain a balance between readability and quality and should seek HONcode certification as it helps establish the reliability and accessibility of the presented information. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"238-244"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/71/63/cise-2023-00290.PMC10497924.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10239868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rotator cuff degeneration and healing after rotator cuff repair.","authors":"Stefano Gumina,&nbsp;Hyungsuk Kim,&nbsp;Younsung Jung,&nbsp;Hyun Seok Song","doi":"10.5397/cise.2023.00430","DOIUrl":"https://doi.org/10.5397/cise.2023.00430","url":null,"abstract":"<p><p>Rotator cuff tear is a common shoulder injury that compromises both function and quality of life. Despite the prevalence of the injury and advancements in repair techniques, a significant percentage of these repairs fail. This review aims to explore the multifactorial reasons behind this failure, including the degenerative nature of the rotator cuff tendon, inherent and extrinsic factors, and the role of hypoxia in tissue degeneration. Additionally, it elucidates potential strategies for improving healing outcomes.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"323-329"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ce/2e/cise-2023-00430.PMC10497920.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does physiotherapy after rotator cuff repair require supervision by a physical therapist?: a meta-analysis.","authors":"Masaki Karasuyama,&nbsp;Masafumi Gotoh,&nbsp;Takuya Oike,&nbsp;Kenichi Nishie,&nbsp;Manaka Shibuya,&nbsp;Hidehiro Nakamura,&nbsp;Hiroki Ohzono,&nbsp;Junichi Kawakami","doi":"10.5397/cise.2022.01410","DOIUrl":"https://doi.org/10.5397/cise.2022.01410","url":null,"abstract":"<p><strong>Background: </strong>A supervised physiotherapy program (SPP) is a standard regimen after surgical rotator cuff repair (RCR); however, the effect of a home-based exercise program (HEP), as an alternative, on postoperative functional recovery remains unclear. Therefore, the purpose of this meta-analysis was to compare the functional effects of SPP and HEP after RCR.</p><p><strong>Methods: </strong>We searched electronic databases including Central, Medline, and Embase in April 2022. The primary outcomes included the Constant score, American Shoulder and Elbow Surgeons score, University of California Los Angeles shoulder score, and pain score. Secondary outcomes included range of motion, muscle strength, retear rate, and patient satisfaction rate. A meta-analysis using random-effects models was performed on the pooled results to determine the significance.</p><p><strong>Results: </strong>The initial database search yielded 848 records, five of which met our criteria. Variables at 3 months after surgery were successfully analyzed, including the Constant score (mean difference, -8.51 points; 95% confidence interval [CI], -32.72 to 15.69; P=0.49) and pain score (mean difference, 0.02 cm; 95% CI, -2.29 to 2.33; P=0.99). There were no significant differences between the SPP and HEP. Other variables were not analyzed owing to the lack of data.</p><p><strong>Conclusions: </strong>Our data showed no significant differences between SSP and HEP with regard to the Constant and pain scores at 3 months after RCR. These results suggest that HEP may be an alternative regimen after RCR. Level of evidence: I.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"296-301"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ac/99/cise-2022-01410.PMC10497919.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10291477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Silicone radial head prostheses revisited: do they have a role in today's practice? A systematic review of literature on clinical outcomes.","authors":"Erik M van Bussel,&nbsp;Anneluuk L Lindenhovius,&nbsp;Bertram The,&nbsp;Denise Eygendaal","doi":"10.5397/cise.2022.00990","DOIUrl":"https://doi.org/10.5397/cise.2022.00990","url":null,"abstract":"<p><strong>Background: </strong>Silicone radial head prostheses (SRHP) are considered obsolete due to reports of frequent failure and destructive silicone-induced synovitis. Considering the good outcomes of modern non-radial silicone joint implants, the extent of scientific evidence for this negative view is unclear. The aim of this research was to systematically analyze the clinical evidence on complications and outcomes of SRHP and how SRHP compare to both non-SRHP and silicone prostheses of other joints.</p><p><strong>Methods: </strong>A systematic literature review was conducted through the Cochrane, PubMed, and Embase databases.</p><p><strong>Results: </strong>Eight cohort studies were included, consisting of 142 patients and follow-up periods ranging from 23 months to 8 years. Average patient satisfaction was 86%, range of 71%-100%, and 58 complications were seen, but no cases of synovitis. These outcomes were in line with non-SRHP. Four case series with 11 cases of synovitis were found, all due to implant fractures years to decades after implantation. Six systematic reviews of currently used non-radial silicone joint implants showed excellent outcomes with low complication rates.</p><p><strong>Conclusions: </strong>Since SRHP have satisfactory clinical results and an acceptable complication rate when selecting a patient group in suitable condition for surgical indications, it is considered that SRHP can still be chosen as a potential surgical treatment method in current clinical practice.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"312-322"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/a0/04/cise-2022-00990.PMC10497923.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10233750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of incidental distal biceps signal changes on magnetic resonance imaging.","authors":"Eugene Kim,&nbsp;Joost T P Kortlever,&nbsp;Amanda I Gonzalez,&nbsp;David Ring,&nbsp;Lee M Reichel","doi":"10.5397/cise.2023.00164","DOIUrl":"https://doi.org/10.5397/cise.2023.00164","url":null,"abstract":"<p><strong>Background: </strong>Knowledge of the base rate of signal changes consistent with distal biceps tendinopathy on magnetic resonance imaging (MRI) has the potential to influence strategies for diagnosis and treatment of people that present with elbow pain. The aim of this study is to measure the prevalence of distal biceps tendon signal changes on MRIs of the elbow by indication for imaging.</p><p><strong>Methods: </strong>MRI data for 1,306 elbows were retrospectively reviewed for mention of signal change in distal biceps tendon. The reports were sorted by indication.</p><p><strong>Results: </strong>Signal changes consistent with distal biceps tendinopathy were noted in 197 of 1,306 (15%) patients, including 34% of patients with biceps pain, 14% of patients with unspecified pain, and 8% of patients with a specific non-biceps indication. Distal biceps tendon changes noted on radiology reports were associated with older age, male sex, and radiologists with musculoskeletal fellowship training.</p><p><strong>Conclusions: </strong>The finding that distal biceps MRI signal changes consistent with tendinopathy are common even in asymptomatic elbows reduces the probability that symptoms correlate with pathology on imaging. The accumulation of signal changes with age, also independent of symptoms, suggests that tendon pathology persists after symptoms resolve, that some degree of distal biceps tendinopathy is common in a human lifetime, and that tendinopathy may often be accommodated without seeking care. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"260-266"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/59/ab/cise-2023-00164.PMC10497931.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally invasive distal biceps tendon repair: a case series.","authors":"Paul Jarrett,&nbsp;Anna-Lisa Baker","doi":"10.5397/cise.2023.00227","DOIUrl":"https://doi.org/10.5397/cise.2023.00227","url":null,"abstract":"<p><strong>Background: </strong>Distal biceps tendon repairs are commonly performed using open techniques. A minimally invasive distal biceps tendon repair technique using a speculum and hooded endoscope was developed to improve visualization, reduce soft-tissue dissection, and minimize complications. This paper describes the technique and reports the outcomes of 75 minimally invasive distal biceps tendon repairs.</p><p><strong>Methods: </strong>The operation reports and outcomes of 75 patients who underwent distal biceps tendon repair using this technique between 2011 and 2021 were retrospectively reviewed.</p><p><strong>Results: </strong>Median time to follow-up was 12 months (interquartile range [IQR], 6-56 months). Primary outcomes were function as measured by the Disabilities of Arm, Shoulder and Hand Score (DASH) questionnaire, and rate of complications. Median DASH score was 1.7 of 100 (IQR, 0-6.8). There were 2 of 75 (2.7%) re-ruptures of the distal tendon. There were no cases of vascular injury, proximal radius fracture, or posterior interosseous nerve, median, or ulnar nerve palsy.</p><p><strong>Conclusions: </strong>In this series, minimally invasive distal biceps repair was safe and effective with a low rate of major complications. Recovery of function, as indicated by low DASH scores, was satisfactory, and inconvenience during recovery was minimized. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"222-230"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f4/b5/cise-2023-00227.PMC10497922.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arthroscopic transosseous anchorless rotator cuff repair reduces bone defects related to peri-implant cyst formation: a comparison with conventional suture anchors using propensity score matching.","authors":"Hyeon Jang Jeong,&nbsp;Ji Soo Lee,&nbsp;Young Kyu Kim,&nbsp;Sung-Min Rhee,&nbsp;Joo Han Oh","doi":"10.5397/cise.2023.00052","DOIUrl":"https://doi.org/10.5397/cise.2023.00052","url":null,"abstract":"<p><strong>Background: </strong>The transosseous anchorless repair (ToR) technique was recently introduced to avoid suture anchor-related problems. While favorable outcomes of the ToR technique have been reported, no previous studies on peri-implant cyst formation with the ToR technique exist. Therefore, this study compared the clinical outcomes and prevalence of peri-implant cyst formation between the ToR technique and the conventional transosseous equivalent technique using suture anchors (SA).</p><p><strong>Methods: </strong>Cases with arthroscopic rotator cuff repair (ARCR) between 2016 and 2018 treated with the double-row suture bridge technique were retrospectively reviewed. Patients were divided into ToR and SA groups. To compare clinical outcomes, 19 ToR and 57 SA cases without intraoperative implant failure were selected using propensity score matching (PSM). While intraoperative implant failure rate was analyzed before PSM, retear rate, peri-implant cyst formation rate, and functional outcomes were compared after PSM.</p><p><strong>Results: </strong>The intraoperative implant failure rate (ToR, 8% vs. SA, 15.3%) and retear rate (ToR, 5.3% vs. SA, 19.3%) did not differ between the two groups (all P>0.05). However, peri-implant cysts were not observed in the ToR group, while they were observed in 16.7% of the SA group (P=0.008). Postoperative functional outcomes were not significantly different between the two groups (all P>0.05).</p><p><strong>Conclusions: </strong>The ToR technique produced comparable clinical outcomes to conventional techniques. Considering the prospect of potential additional surgeries, the absence of peri-implant cyst formation might be an advantage of ToR. Furthermore, ToR might reduce the medical costs related to suture anchors and, thereby, could be a useful option for ARCR. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"276-286"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/3d/cise-2023-00052.PMC10497926.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10292006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the effects of age on the long-term functional outcomes following anatomic total shoulder arthroplasty.","authors":"Troy Li,&nbsp;Akiro H Duey,&nbsp;Christopher A White,&nbsp;Amit Pujari,&nbsp;Akshar V Patel,&nbsp;Bashar Zaidat,&nbsp;Christine S Williams,&nbsp;Alexis Williams,&nbsp;Carl M Cirino,&nbsp;Dave Shukla,&nbsp;Bradford O Parsons,&nbsp;Evan L Flatow,&nbsp;Paul J Cagle","doi":"10.5397/cise.2023.00409","DOIUrl":"https://doi.org/10.5397/cise.2023.00409","url":null,"abstract":"<p><strong>Background: </strong>In the past decade, the number of anatomic total shoulder arthroplasty (aTSA) procedures has steadily increased. Patients over 65 years of age comprise the vast majority of recipients, and outcomes have been well documented; however, patients are opting for definitive surgical treatment at younger ages.We aim to report on the effects of age on the long-term clinical outcomes following aTSA.</p><p><strong>Methods: </strong>Among the patients who underwent TSA, 119 shoulders were retrospectively analyzed. Preoperative and postoperative clinical outcome data were collected. Linear regression analysis (univariate and multivariate) was conducted to evaluate the associations of clinical outcomes with age. Kaplan-Meier curves and Cox regression analyses were performed to evaluate implant survival.</p><p><strong>Results: </strong>At final follow-up, patients of all ages undergoing aTSA experienced significant and sustained improvements in all primary outcome measures compared with preoperative values. Based on multivariate analysis, age at the time of surgery was a significant predictor of postoperative outcomes. Excellent implant survival was observed over the course of this study, and Cox regression survival analysis indicated age and sex to not be associated with an increased risk of implant failure.</p><p><strong>Conclusions: </strong>When controlling for sex and follow-up duration, older age was associated with significantly better patient-reported outcome measures. Despite this difference, we noted no significant effects on range of motion or implant survival. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"231-237"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/6c/cise-2023-00409.PMC10497918.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10236518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk factors for unexpected readmission and reoperation following open procedures for shoulder instability: a national database study of 1,942 cases.","authors":"John M Tarazi,&nbsp;Matthew J Partan,&nbsp;Alton Daley,&nbsp;Brandon Klein,&nbsp;Luke Bartlett,&nbsp;Randy M Cohn","doi":"10.5397/cise.2023.00178","DOIUrl":"https://doi.org/10.5397/cise.2023.00178","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study was to identify demographics and risk factors associated with unplanned 30-day readmission and reoperation following open procedures for shoulder instability and examine recent trends in open shoulder instability procedures.</p><p><strong>Methods: </strong>The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried using current procedural terminology (CPT) codes 23455, 23460, and 23462 to find patients who underwent shoulder instability surgery from 2015 to 2019. Independent sample Student t-tests and chi-square tests were used in univariate analyses to identify demographic, lifestyle, and perioperative variables related to 30-day readmission following repair for shoulder instability. Multivariate logistic regression modeling was subsequently performed.</p><p><strong>Results: </strong>In total, 1,942 cases of open surgical procedures for shoulder instability were identified. Within our study sample, 1.27% of patients were readmitted within 30 days of surgery, and 0.85% required reoperation. Multivariate logistic regression modeling confirmed that the following patient variables were associated with a statistically significant increase in the odds of readmission: open anterior bone block/Latarjet-Bristow procedure, being a current smoker, and a long hospital stay (all P<0.05). Multivariate logistic regression modeling confirmed statistically significant increased odds of reoperation with an open anterior bone block or Latarjet-Bristow procedure (P<0.05).</p><p><strong>Conclusions: </strong>Unplanned 30-day readmission and reoperation after open shoulder instability surgery is infrequent. Patients who are current smokers, have an open anterior bone block or Latarjet-Bristow procedure, or a longer than average hospital stay have higher odds of readmission than others. Patients who undergo an open anterior bone block or Latarjet-Bristow procedure have higher odds of reoperation than those who undergo an open soft-tissue procedure. Level of evidence: III.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"252-259"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/97/5f/cise-2023-00178.PMC10497916.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10241781","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variability in physical therapy protocols following total shoulder arthroplasty.","authors":"Samuel Schick,&nbsp;Alex Dombrowsky,&nbsp;Jamal Egbaria,&nbsp;Kyle D Paul,&nbsp;Eugene Brabston,&nbsp;Amit Momaya,&nbsp;Brent Ponce","doi":"10.5397/cise.2023.00115","DOIUrl":"https://doi.org/10.5397/cise.2023.00115","url":null,"abstract":"<p><strong>Background: </strong>Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA.</p><p><strong>Methods: </strong>PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity.</p><p><strong>Results: </strong>Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks).</p><p><strong>Conclusions: </strong>Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.</p>","PeriodicalId":33981,"journal":{"name":"Clinics in Shoulder and Elbow","volume":"26 3","pages":"267-275"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/8a/9a/cise-2023-00115.PMC10497930.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10586095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}