Background: Rehabilitation after Reverse Shoulder Arthroplasty (RSA) is still object of discussion with no based evidence guidelines. The aim of this study was to test a personalized rehabilitation protocol for three different patients groups according to clinical and intraoperative parameters that can affect final outcomes after RSA.
Patients and methods: We retrospectively evaluated a consecutive series of 112 patients who underwent to RSA between 2013 and 2015. The average follow-up was 29.2 months. A preoperative and postoperative clinical and radiographic assessment was performed. According to clinical, radiographic and intraoperative parameters, we selected three groups dedicating each one a specific level of post surgical care.
Results: A statistically significant improvement was achieved from preoperative evaluation, regarding all analysed parameters. Notable improvements were reported in high care group: elevation improved of 63.9° despite of Group A 55.5° and Group B 54.5° and it resulted statistically significant (p< 0.05). Costant Score increased of 35.9%, despite of Group A and Group B respectively 40.6% and 34.8% (p> 0.05).
Conclusion: Our study shows that a personalized rehabilitation protocol can be effective improving clinical outcomes and decreasing complications rate, particularly in difficult management patients.
Level of evidence: Therapeutic Level IV.
Keywords: complications; onlay design; radiological results; rehabilitation protocol; reverse shoulder arthroplasty; scapular notching.