title: Patient Activity Levels After Reverse Total Shoulder Arthroplasty: What Are Patients Doing?
abstract: BACKGROUND
  The indications for reverse total shoulder arthroplasty (RTSA) continue to expand, which has resulted in younger patients who want to remain active after RTSA. Little information is available to manage expectations of both physicians and patients for return to sporting activities.
  
  
  OBJECTIVE
  To determine the rate of return to sporting activities and assess average time to return to sports after RTSA.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  This was a retrospective review of consecutive RTSA patients collected from our institution's shoulder arthroplasty registry. All patients who played sports preoperatively and had a minimum of 1-year follow-up were included. Final follow-up consisted of an additional patient-reported questionnaire with questions regarding physical fitness and sporting activities. Each patient also completed an assessment with the American Shoulder and Elbow Society (ASES) Shoulder Score and a visual analog scale (VAS) for pain.
  
  
  RESULTS
  Seventy-six patients played a sport preoperatively and met inclusion and exclusion criteria. The average follow-up was 31.6 months (range, 12-65 months), and average age was 74.8 years (range, 49.9-92.6 years). Average VAS pain scores improved from 6.57 to 0.63 (P < .001). Average ASES scores improved from 34.30 to 81.45 (P < .001). Subjectively, 11.8% of patients complained of stiffness and 10.5% complained of chronic pain. After RTSA, 85.5% of patients returned to at least 1 sport. Average time to return to full sports was 5.3 months. Fitness sports had the highest direct rate of return (81.5%), followed by swimming (66.7%), running (57.1%), cycling (50.0%), and golf (50%). Postoperatively, 41.1% of patients reported improved physical fitness; 88.2% felt that their sports outcome was good to excellent, and 93.4% felt that their surgical outcome was good to excellent.
  
  
  CONCLUSIONS
  Patients undergoing RTSA had an 85% rate of return to 1 or more sporting activities at an average of 5.3 months after surgery. Age greater than 70 years was a significant predictor of decreased return to activities. The present study offers valuable information to help manage patient and surgeon expectations.
authors: Hospital for Special Surgery, New York, New York, USA GarciaGr@hss.edu.
authors: Grant H
authors: GH
authors: Garcia
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Samuel A
authors: SA
authors: Taylor
authors: Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.
authors: Brian J
authors: BJ
authors: DePalma
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Gregory T
authors: GT
authors: Mahony
authors: University of Cincinnati Department of Orthopaedic Surgery, Cincinnati, Ohio, USA.
authors: Brian M
authors: BM
authors: Grawe
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Joseph
authors: J
authors: Nguyen
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Joshua S
authors: JS
authors: Dines
authors: Hospital for Special Surgery, New York, New York, USA.
authors: David M
authors: DM
authors: Dines
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Russell F
authors: RF
authors: Warren
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Edward V
authors: EV
authors: Craig
authors: Hospital for Special Surgery, New York, New York, USA.
authors: Lawrence V
authors: LV
authors: Gulotta
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019643:Arthroplasty, Replacement / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D012189:Retrospective Studies; D012785:Shoulder Joint / Q000601:surgery*; D013177:Sports; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: physical fitness; reverse total shoulder arthroplasty; shoulder replacement; sports