title: Pattern of recovery following total shoulder arthroplasty and humeral head replacement.
abstract: BACKGROUND
  Understanding the pattern of recovery and expected rate of change after shoulder arthroplasty is helpful to clinicians and patients for setting realistic expectations and goals. The purpose of this study was to describe the pattern of recovery over a 2-year period for patients receiving either a Total Shoulder Arthroplasty (TSA) or Humeral Head Replacement (HHR).
  
  
  METHODS
  This was a secondary analysis of prospectively collected data of patients who had undergone TSA or HHR and were followed for up to 2 years. Patients were seen prior to surgery and at 6 months, one year and two years after surgery and completed the American Shoulder and Elbow Surgeon's (ASES) questionnaire, Relative Constant Murley score (RCMS) and underwent range of motion and strength assessment.
  
  
  RESULTS
  Data of 134 patients who had surgery from April 2001 to July 2011 were used for analysis. One hundred and eight patients underwent TSA (81%) and 26 (19%) had HHR. Both surgeries were associated with a statistically significant improvement in physical symptoms, ASES, RCMS, range of motion and strength (p <0.0001). The greatest change for all outcomes occurred within the first 6-months of surgery. Improvement in ASES, RCMS continued up to 12-months and then plateaued. Improvement in physical symptoms leveled off at 6-months in the HHR group but continued up to 12-months in the TSR group. Strength showed improvement in both groups up to 24-months post-surgery.
  
  
  CONCLUSIONS
  Both TSA and HHR groups showed a statistically significant improvement in perceived disability, range of motion and strength over two years with the greatest improvement made by 6 months. The recovery profiles for the surgeries showed different patterns.
authors.affiliation: Holland Orthopaedic & Arthritic Centre, Sunnybrook Health Sciences Centre, 43 Wellesley Street East, Toronto, Ontario M1Y 1H1, Canada. helen.razmjou@sunnybrook.ca.
authors.forename: Helen
authors.initials: H
authors.lastname: Razmjou
authors.forename: Paul
authors.initials: P
authors.lastname: Stratford
authors.forename: Deborah
authors.initials: D
authors.lastname: Kennedy
authors.forename: Richard
authors.initials: R
authors.lastname: Holtby
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000639:trends*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D058430:Humeral Head / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000175:diagnosis* / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D016896:Treatment Outcome