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Study reveals variation in surgeon preference for return to sports after shoulder procedures
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According to the results of an online survey, shoulder surgeons recommend a more aggressive return to sport after shoulder resurfacing and humeral hemiarthroplasty, and call for a more conservative return to sport after reverse total shoulder arthroplasty.
Dimitrios C. Christoforou, MD, presented the findings of the study at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons in New Orleans.
“There is limited information available in the published literature,” Christoforou said. “Most of the studies are not recent and encompass only a few arthroplasty options. As a result of this, we sought to obtain experienced consensus opinion regarding return to sports following various shoulder arthroplasty options which can be used as a guideline to counsel patients before and after surgery.”
Study methods and parameters
Christoforou and colleagues investigated surgeon preferences regarding patients’ return to sports after total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), humeral hemiarthroplasty (HHA) and humeral head resurfacing (HHR) with and without glenoid resurfacing.
The investigators conducted the survey with American Shoulder and Elbow Surgeons members. The surgeons were asked about their preferences for allowing patients’ full, limited or no participation in a particular sport (of 32 listed sports) after TSA, RTSA, HHA and HHR with or without glenoid resurfacing. The surgeons were also asked when they allowed patients to return to sports after shoulder arthroplasty.
Lowest return after total shoulder
Fifty-two surgeons responded to the survey. Sporting activities that predominantly involve the use of the upper extremities were subdivided into three categories: noncontact low-impact, noncontact high-impact, and contact sports.
The investigators found a statistically significant difference when allowing full-sports participation after TSA was compared with that after HHR with and without glenoid resurfacing, HHA and RTSA.
“When looking at specific types of activities, [we] found the lowest allowance for return after reverse total shoulder and the highest following humeral-hemi resurfacing,” Christoforou said.
“When comparing all groupings of sports combined based on the type of arthroplasty, we again found more sports allowed for humeral head resurfacing and hemiarthroplasty, followed by totals, and least following reverse total shoulder arthroplasty,” he added.
Aggressive vs. conservative
Christoforou said the findings suggest that surgeons who perform shoulder arthroplasty allow a more aggressive return to sports after shoulder resurfacing and humeral hemiarthroplasty. Furthermore, a more conservative return to sports after reverse total shoulder arthroplasty seems to be recommended.
“It is important to remember that these are surgeon preferences,” Christoforou noted. “Long-term outcome studies are needed to assess whether these surgeon preferences are clinically supported by implant survival data in patients participating in sports after shoulder arthroplasty.”
- Reference:
Christoforou DC, Golant A, Kwon YW, Zuckerman JD. Sports participation after shoulder arthroplasty. Paper 176. Presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons March 9-13, 2010. New Orleans.
