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. 2022 Nov 21;10(11):23259671221136304.
doi: 10.1177/23259671221136304. eCollection 2022 Nov.

Sports Participation After Reverse Total Shoulder Replacement

Hilal S A Al Housni  1   2 , Patrick H Lam  1   3 , Joseph W Latif  3 , George A C Murrell  1   3
Affiliations

Sports Participation After Reverse Total Shoulder Replacement

Hilal S A Al Housni et al. Orthop J Sports Med. .

Abstract

Background: Reverse total shoulder replacement (RTSR) is becoming a popular and reliable treatment for rotator cuff arthropathy. However, little is known about the ability to participate in sports after surgery.

Purpose: To determine to what extent RTSR will allow patients to participate in sporting activities and identify the associated factors that could affect postoperative sports participation.

Study design: Case series; Level of evidence, 4.

Methods: Data were collected prospectively from patients who underwent RTSR over a 10-year period from April 2009 to May 2019. Patients were assessed before surgery, at 6 months after surgery, and at the final follow-up. Patients were asked within a validated shoulder questionnaire to rank their current highest level of sports participation, overall shoulder status, frequency of pain, level of pain, and functional levels. Their shoulder range of motion and strength were assessed before surgery and at 6 months after surgery.

Results: The study included 108 shoulders (106 patients). The mean age was 74 years (range, 51-88 years), with 44 men and 64 women. The mean follow-up was 4 years. Overall shoulder satisfaction, frequency and levels of pain, and shoulder function improved significantly at 6 months and 4 years (P < .0001). External rotation, abduction, and forward flexion range of motion improved significantly at 6 months (P < .05 for all). The strength of internal rotation, external rotation, abduction, and adduction improved significantly at 6 months (P < .001 for all). The rate of return to sports was 67% at 6 months and 48% at 4 years. Multiple significantly associated factors were identified with return to sports at 6 months, including sex and age.

Conclusion: The rate of return to sports after RTSR is high. Around two-thirds of patients can return to sports at 6 months postoperatively, although the results slightly deteriorate over time (48% at 4 years).

Keywords: arthroplasty; reverse replacement; shoulder; sport.

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Conflict of interest statement

One or more of the authors has declared the following potential conflict of interest or source of funding: G.A.C.M. has received research support and consulting fees from Smith & Nephew. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto.

Figures

Figure 1.
Figure 1.
CONSORT flowchart of included and excluded patients in this study. RTSA, reverse total shoulder arthroplasty.
Figure 2.
Figure 2.
Mean patient-reported responses for (A) overall shoulder satisfaction (B) frequency of pain, (C) level of pain, and (D) shoulder function after reverse total shoulder replacement. Error bars indicate SEM. Statistically significant difference (Kruskal-Wallis test): ****P < .0001. RTSA, reverse total shoulder arthroplasty.
Figure 3.
Figure 3.
Improvement in (A) range of motion and (B) strength after reverse total shoulder arthroplasty. Statistically significant difference vs preoperative (paired sample t test): ****P < .0001. ***P < .001. *P < .05.
Figure 4.
Figure 4.
Levels of sports participation preoperatively, at 6 months postoperatively, and at a mean 4 years postoperatively.
Figure 5.
Figure 5.
(A) Rates of return to sports at 6 months and 4 years after reverse total shoulder replacement. (B) Sports participation after surgery for those who could not participate before surgery. (C) Sports played as reported by patients at the most recent follow-up (4 years).
See this image and copyright information in PMC

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