Philippossian Robin, Luthi François, Farron Alain, Pichonnaz Claude
Service d'orthopédie et de traumatologie, Département de l'appareil locomoteur, CHUV et Université de Lausanne, 1011 Lausanne.
Clinique romande de réadaptation, Service de réadaptation de l'appareil locomoteur, Av. Grand-Champsec 90, 1950 Sion.
Rev Med Suisse. 2019 Jul 10;15(657):1340-1349.
This article aims to present the principles of rehabilitation following anatomical and reverse total shoulder arthroplasties. The rehabilitation consist of three phases: wound healing and movement initiation (weeks 0-6), movement recovery (7-12), strengthening and return to activity (13-18). At 6 to 12 months follow-up, most patients report a substantial decrease in pain and a return to light to moderate activity level. The rehabilitation of the reverse arthroplasty specifically requires deltoid muscle strengthening and dislocation prevention. The functional outcome is slightly inferior for reverse arthroplasty, which is indicated when musculotendinous lesions are associated to bone lesions, but satisfaction rates are comparable between the two types of implants. The durability of total shoulder arthroplasties is globally satisfying, though shorter in young active patients.
本文旨在阐述解剖型和反置式全肩关节置换术后的康复原则。康复过程分为三个阶段：伤口愈合与活动起始期（0 - 6周）、活动恢复阶段（7 - 12周）、强化训练与恢复日常活动阶段（13 - 18周）。在6至12个月的随访中，大多数患者报告疼痛显著减轻，并恢复到轻度至中度的活动水平。反置式置换术的康复特别需要加强三角肌力量和预防脱位。当肌腱肌肉损伤与骨损伤相关时，反置式置换术的功能结果略逊一筹，但两种植入物类型的满意度相当。全肩关节置换术的耐用性总体令人满意，不过在年轻活跃患者中耐用时间较短。
