High Return to Sports after TSA Under 55

Abstract

Objectives: Young, active shoulder arthroplasty candidates are a unique group of patients. Not only due they demand longevity and improved function, but they also desire a return to physical activities. Our objective was to determine the rate of return to sports in total shoulder arthroplasty patients’ age 55 and younger. Methods: This was a retrospective review of consecutive patients who underwent total shoulder arthroplasty at a single institution. Exclusion criteria included age at surgery greater than 55 years and less than 2 years of follow up. Final follow-up consisted of a patient-reported sports questionnaire, ASES and VAS scores. Results: 61 shoulders were included with an average follow-up of 61.0 months (23-103) and average age at surgery of 48.9 years (25-55). VAS improved from 5.6 to 0.9 (p<0.001), and ASES improved from 39.3 to 88.4 (p<0.001). 80.3% (49) were done for osteoarthritis. 4 shoulders returned to the operating room, none were for glenoid loosening. There was a 93.2% satisfaction rate and 67.7% (40) stated they had their surgery to return to sports. 96.4% (55/57) restarted at least one sport at an average of 6.7 months. Direct rates of return were as follows: fitness sports (97.2%), golf (93.3%), singles tennis (87.5%), swimming (87.5%), basketball (75%) and flag football (66.7%). 82.4% (47) returned to similar or higher level of sport. 90.3% returned to a high demand sport and 83.8% returned to a high upper extremity use sport. There was no significant difference in rate of return to sport by BMI, sex, age, preoperative diagnosis, revision status, and dominant extremity. Conclusion: In patients age 55 and younger undergoing total shoulder arthroplasty, there was a 96.4% rate of return to sports at an average of 6.7 months. Furthermore, at an average follow up of 5 years, no patients needed revision of their glenoid component despite an 83.8% rate of return to high upper extremity use sports. While caution should still be advised in young active patients undergoing total shoulder replacement, these results demonstrate a high satisfaction rate and improved ability to return patients to most sports after surgery.