Is the use of abduction pillows crucial for post-operative rehabilitation following reverse total shoulder arthroplasty?

Abstract

Surgeons often use abduction pillows after reverse total shoulder arthroplasty (rTSA), but evidence for their benefits is limited. This study compares outcomes for patients using a sling with or without an abduction pillow post-operatively. A retrospective review was conducted on patients undergoing primary rTSA. Patients were grouped based on post-operative use of an abduction pillow or not. Data was collected at 6 weeks, 3 months, 6 months, 1 year, and final follow-up. Primary outcomes included rates of post-operative dislocation, range of motion, and patient-reported outcomes. Patients using an abduction pillow showed reduced forward flexion at 3 months (120° vs. 139°, p = 0.002) and 6 months (135° vs. 147°, p = 0.049). At 6 weeks, abduction was lower in the pillow group (90° vs. 124°, p = 0.01). There were no significant differences in other range-of-motion metrics or patient-reported outcomes. Using no pillow did not increase dislocation risk (OR: 1.67, p = 0.60), infection, readmission, revision, or repeat surgery rates. Post-operative sling use without an abduction pillow after rTSA appears safe, with no increase in complications and similar patient satisfaction and outcomes. Therapeutic Level III.