Original Research

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Publish date: May 23, 2018

Jennifer Kurowicki, MD

Samuel Rosas, MD

Tsun Yee Law, MD

Jonathan C. Levy, MD

TAKE-HOME POINTS

Both anatomic (TSA) and reverse shoulder arthroplasty (RSA) allow for the participation in work and sports.
TSA patients report easier overall ability to participate in sports, specifically golf and swimming.
For sports involving shoulder function, TSA patients more commonly report maximal ability to participate than RSA patients.
TSA patients report easier overall ability to return to work-related activities, specifically housework and gardening.
TSA patients featured 27% higher sport-specific ASES scores and 21% higher work-specific ASES scores than RSA patients.

References

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12. Nolan BM, Ankerson E, Wiater JM. Reverse total shoulder arthroplasty improves function in cuff tear arthropathy. Clin Orthop Relat Res. 2011;469(9):2476-2482. doi:10.1007/s11999-010-1683-z.

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ABSTRACT

Both anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are routinely performed for patients who desire to continuously work or participate in sports. This study analyzes and compares the ability of patients to work and partake in sports following shoulder arthroplasty based on responses to clinical outcome surveys.

A retrospective review of the shoulder surgery repository was performed for all patients treated with TSA and RSA and who completed questions 9 and 10 on the activity patient self-evaluation portion of the American Shoulder and Elbow Surgeons (ASES) Assessment Form. Patients with a minimum of 1-year follow-up were included if a sport or work was identified. The analysis included 162 patients with TSA and 114 patients with RSA. Comparisons were made between TSA and RSA in terms of the specific ASES scores (rated 0-3) reported for ability to work and participate in sports and total ASES scores, and scores based on specific sports or line of work reported. Comparisons were also made between sports predominantly using shoulder function and those that do not.

TSA patients had a 27% higher ability to participate in sports (average specific ASES score: 2.5 vs 1.9, P < .001) than RSA patients and presented significantly higher scores for swimming and golf. Compared with RSA patients, TSA patients demonstrated more ability to participate in sports requiring shoulder function without difficulty, as 63% reported maximal scores (P = .003). Total shoulder arthroplasty patients also demonstrated a 21% higher ability to work than RSA patients (average specific ASES scores: 2.6 vs 2.1, P < .001), yielding significantly higher scores for housework and gardening.

Both TSA and RSA allow for participation in work and sports, with TSA patients reporting better overall ability to participate. For sports involving shoulder function, TSA patients more commonly report maximal ability to participate than RSA patients.

End-stage shoulder arthritis has been successfully treated with anatomical total shoulder arthroplasty (TSA) with high rates of functional recovery.¹ With the introduction of reverse shoulder arthroplasty (RSA), indications for TSA have expanded.^2-6 With continuing expansion of surgical indications, a more diverse and potentially active patient population is now being treated. As patients exhibit increased awareness of health and wellness, they demonstrate significant interest in understanding their ability to work or participate in sports after surgery.⁷ Patients no longer focus on pain relief as the only goal of surgery. A recent study of patients aged 65 years and undergoing shoulder arthroplasty revealed that 64% of the patients listed the ability to return to sports as the main reason for undergoing surgery,⁸ highlighting the significance of sports play in a patient’s life. Prior to surgery, shoulder pathologies lead to impairment in function, range of motion, and pain,⁹ hindering a patient to participate in both work and sports. With the intervention yielding improvement to these areas^6,9-13with increased patient satisfaction,^10,13 accurately tailoring patient expectations for participation in sports and work postoperatively becomes increasingly important.

Continue to: Although several studies...

References

8. McCarty EC, Marx RG, Maerz D, Altchek D, Warren RF. Sports participation after shoulder replacement surgery. Am J Sports Med. 2008;36(8):1577-1581. doi:10.1177/0363546508317126.

10. Deshmukh AV, Koris M, Zurakowski D, Thornhill TS. Total shoulder arthroplasty: long-term survivorship, functional outcome, and quality of life. J Shoulder Elbow Surg. 2005;14(5):471-479.

12. Nolan BM, Ankerson E, Wiater JM. Reverse total shoulder arthroplasty improves function in cuff tear arthropathy. Clin Orthop Relat Res. 2011;469(9):2476-2482. doi:10.1007/s11999-010-1683-z.

13. Norris TR, Iannotti JP. Functional outcome after shoulder arthroplasty for primary osteoarthritis: a multicenter study. J Shoulder Elbow Surg. 2002;11(2):130-135.

15. Healy WL, Iorio R, Lemos MJ. Athletic activity after joint replacement. Am J Sports Med. 2001;29(3):377-388.

16. Jensen KL, Rockwood CA Jr. Shoulder arthroplasty in recreational golfers. J Shoulder Elbow Surg. 1998;7(4):362-367.

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

TAKE-HOME POINTS

References

ABSTRACT

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