8.29 TSA

Question 1

Why would someone need a TSA?

Answer 1

• bad OA, RA
• breast cancer
• AVN
• fx that can’t be fixed
• janky RTC

Question 2

TSA vs salvage

Answer 2

• save as much as they can, but may not be able to salvage the tissue
• need TSA instead of RTC repair

Question 3

When does rehab begin for a TSA generally?

Answer 3

about 6 weeks post-op

Question 4

What happens within the first 6 weeks post-op for a TSA?

Answer 4

• PROM
• mobs
• isometrics
• don’t usually see them a lot at the beginning or they’ll use their visits up

Question 5

Why should a TSA pt be seen by PT at least once?

Answer 5

• Ability to walk and balance: are they safe after surgery?
• What happens if they were using a walker? Do we need to change the assistive device?
• Are they safe to go home?
• Bed mobility?

Question 6

What types of exercises will be done for TSA in the hospital?

Answer 6

• some pendulum stuff

- work on distal joints

Question 7

Why do TSA pts do pendulum exercises?

Answer 7

• distraction should feel better

- supposed to be PROM

Question 8

Why is it so important to do exercises for the distal arm after a TSA?

Answer 8

don’t want atrophy below the surgical site

Question 9

Why should pts not squeeze a tennis ball for grip exercises?

Answer 9

• causes more finger splaying

- doesn’t mimic normal grip

Question 10

3 categories of education for daily life after a TSA

Answer 10

• hygiene
• toilet
• dressing

Question 11

TSA and sweaty pits

Answer 11

• must wash/dry at least 1x per day
• don’t use powder: just holds in moisture
• high risk of infection from fromunda cheese

Question 12

TSA and toilet stuff

Answer 12

may have to wipe with nondominant hand

Question 13

Is there a benefit to getting a TSA?

Answer 13

• decent results

- better than if nothing was done

Question 14

Why would a reverse TSA be performed?

Answer 14

• if the RTC is totally jacked up

- can use the delts to take the place of RTC muscles and create movements

Question 15

How do the delts work with a normal TSA?

Answer 15

• delts fire to produce humeral elevation before there’s any rotation
• lots of glide before it gets stuck and rolls

Question 16

How do the delts work with a reverse TSA?

Answer 16

• delts have greater mechanical advantage

- doesn’t require as much strength to move the humerus

Question 17

Does the rehab protocol for a reverse TSA differ from a normal TSA?

Answer 17

no: same slow and meticulous methods

have to decide how to space out visits