Return to Sports After Primary Reverse Shoulder Arthroplasty: Outcomes at Mean 4-Year Follow-up

Abstract

Background: With the expanding use of reverse shoulder arthroplasty (RSA) to treat various shoulder conditions, there has been a rise in the number of RSAs performed, especially in physically active patients. Limited information regarding sports after RSA is available to properly counsel patients on postoperative expectations. Purpose: To assess the rate of return to sports as well as the ability to return to the same level of preoperative intensity, frequency, and duration of sport after primary RSA. Study Design: Case series; Level of evidence, 4. Methods: This was a retrospective review of patients who underwent primary RSA at our institution between 2014 and 2016. Shoulder motion, Subjective Shoulder Value score, American Shoulder and Elbow Surgeons score, pre- and postoperative sports activities, and barriers to return to sport were assessed in 109 patients after RSA (93 patients with unilateral RSA and 16 patients with bilateral RSA). The mean age at the time of surgery was 70 years (range, 34-86 years), with a mean follow-up of 3.9 years (range, 2-12 years). Results: The mean rate of return to sports was 70.1% (range, 0%-100%). There was no difference in return to sports between those with uni- and bilateral RSA ( P = .64). Fishing, swimming, elliptical/treadmill, and hunting were the most common sports after RSA with return rates of 91%, 73%, 86%, and 82% respectively. A majority of patients returned to the same level of preoperative intensity, frequency, and duration for all sports except for climbing and swimming. There was a lower mean rate of return for high-demand sports (62.9%) compared with low- and medium-demand sports (76.7%) ( P = .005). The most common reasons for inability to return to sports included limited motion, fear of injury, and weakness. Conclusion: Patients who had undergone primary uni- or bilateral RSA reported a 70.1% rate of return to sports with maintenance of the same level of intensity, duration, and frequency of preoperative sport participation. Rates of return to high-demand sports were lower than low- and medium-demand sports. Patients also had difficulty returning to overhead sports.

Return-to-Golf Rate After Shoulder Arthroplasty: A Systematic Review and Meta-analysis

“…4 The indication for RSA being osteoarthritis or rheumatoid arthritis has been reported to have higher returnto-sport rates than cuff tear arthropathy and fracture (100% vs 76%-81%). 6 Hand dominance did not affect the return-to-sport rate for HA or TSA in 2 studies 5,11 and for RSA in 1 study, 6 but Tangtiphaiboontana et al 18 reported that the laterality of RSA affected return to sport, with a 38% return-to-sport rate after right-sided RSA compared with 71% after left-sided RSA, although the hand dominance of the patients was not specified. Bilateral RSA was reported to have similar return-to-sport rates as unilateral RSA (69% vs 76%, respectively).…”

“…Bilateral RSA was reported to have similar return-to-sport rates as unilateral RSA (69% vs 76%, respectively). 18 Will Golf Be Painful After Surgery? Three studies 9,11,16 reported details about pain during or after rounds of golf after arthroplasty.…”

“…Studies have found that 64% of patients chose to undergo arthroplasty in order to return to sport 11 and approximately 70% of patients participated in recreational sports within 4 years of shoulder arthroplasty. 18 The primary purpose of this study was to systematically review the literature for rates of return to golf after anatomic total shoulder arthroplasty (TSA), hemiarthroplasty (HA), and reverse shoulder arthroplasty (RSA). The secondary purposes included other topics relevant to golfers undergoing shoulder arthroplasty, as follows:…”

“…Studies have found that 64% of patients chose to undergo arthroplasty in order to return to sport 11 and approximately 70% of patients participated in recreational sports within 4 years of shoulder arthroplasty. 18 …”

Return to Sports Activity After Reverse Total Shoulder Arthroplasty

“…§ However, there are few studies on RTS activity after RTSA. 5,11,25,44,46 From the current studies, it is unclear as to how to predict the probability and appropriate timing of RTS activities after surgery. 13,33 Moreover, the types of sports played are likely to be different across different cultures/ethnicities.…”