Sports Activity after Anatomical Total Shoulder Arthroplasty

Background Implant functionality has clearly increased over the past decades because of improvements in total shoulder arthroplasty systems. This means that prostheses are now being implanted in younger patients with high sports activity. Hypothesis The implantation of the total shoulder arthroplasty does not mainly influence the sports activity. Study Design Case series; Level of evidence, 4. Methods One hundred consecutive patients with unilateral total shoulder arthroplasty, followed for at least 1 year, were included in the study. Assessment preoperatively and 1 year and 2 years after operation included clinical examination and a validated questionnaire (Constant, Shoulder Pain and Disability Index [SPADI], and Disabilities of the Arm, Shoulder and Hand [DASH] scores, and the Short Form 36 [SF-36]). In addition, all patients received a sports questionnaire developed in house. Results Of the 55 patients who took part in sports before having shoulder disease, 49 (89%) were still able to participate after a mean follow-up of 2.8 years (range, 1.3-4.6 years). Seventeen patients had given up sports before total shoulder arthroplasty; 11 of them resumed activities after joint replacement but 6 did not start again. No patient had to stop sports because of the total shoulder arthroplasty. The sports most commonly mentioned were swimming (10 patients [20.4%]), golf (8 patients [16.3%]), cycling (8 patients [16.3%]), and fitness training (8 patients [16.3%]). Strength and range of motion, as well as the physical component summary (PCS) of the SF-36 and the Constant score (CS) after total shoulder arthroplasty, were significantly better in the sports group (49 of 100; PCS = 46, CS = 77) than in the nonsports group (45 of 100; PCS = 41,CS = 71). Eighteen patients (36.7%) stated that even after joint replacement, they still suffered restrictions on their sports activities because of shoulder problems. Whereas the overall mean age at follow-up was 68.9 years (range, 26-92 years), the mean age of patients participating in sports was significantly lower than in the nonsports group (63 vs 70 years; P = .002). Conclusion Total shoulder arthroplasty allows patients to participate in sports without significant restriction of their level of activity. The probability of being able to do sports postoperatively—if done preoperatively—is high. Long-term studies are needed to determine whether the greater loading on the joint will lead to more rapid wear and a higher rate of loosening with time.