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Dr Matsen, and Sarah Jackins PT, have an excellent protocol, outlined in a book, sorry I am not sure of the title. Essentially, Do not work on abduction. The folks we see get 140 degrees forward elevation (flexion) and 40 degrees external rotation by discharge, 2 or 3 days after surgery. This is passive or active assist. They carry on 3 reps 5 times a day until 6 weeks when they do a strengthening program. No resisted internal rotation to avoid re avulsing subscapularis. Any specific questions,and I can ask Sarah, as I work with her. Tracey. -------- >From: [log in to unmask] >To: [log in to unmask] >Subject: RE: Total Shoulder(s) >Date: February 23, 1999 > > >Dear Listers, > >I have recently had a patient referred who has had avascular necrosis in >multiple joints(sickle cell anemia based). She has presently undergone >a THR(L), TSR(R) and will soon be going for a second TSR(L). I have >only seen a couple TSR patients and I was wondering re protocols and >limitations. As I remember there was only an expectation that the >patient should achieve 90' active flexion/abduction(because of the >design of the prosthesis). Can anyone inform me of recent expectations >for these joint replacements? I would be grateful to anyone who can >send me an up to date protocol. Thanks, Ross. > %%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%%