title: Sports- and Work-Related Outcomes After Shoulder Hemiarthroplasty.
abstract: BACKGROUND
  With an active aging population, more patients expect to return to previous activities and work after surgery.
  
  
  OBJECTIVE
  To determine the rate and timing to return of sports and employment after shoulder hemiarthroplasty.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  This was a retrospective review of consecutive patients who underwent shoulder hemiarthroplasty from 2007 to 2013. Follow-up consisted of a patient-reported questionnaire regarding physical fitness, sporting activities, and work status.
  
  
  RESULTS
  From 105 patients screened, 79 were available for follow-up. The average follow-up time was 63.1 months, and the average age at follow-up was 69 years. Scores on the visual analog scale for pain improved from 6.2 to 2.1 (P < .001) postoperatively, and those on the American Shoulder and Elbow Surgeons (ASES) shoulder assessment improved from 34.6 to 71.3 (P < .001). Patients older than 65 years had significantly lower absolute postoperative ASES scores (P = .041) but experienced similar improvement from their preoperative baseline (P = .158) compared with patients younger than 65 years. There were 58 patients who played sports preoperatively, and 67.2% of these restarted at least 1 of their previous sports postoperatively. The average time to return to full sports was 6.5 months for those who returned. Direct rates of return were as follows: fitness sports (69%), swimming (65%), running (64%), cycling (63%), and doubles tennis (57%). Younger age was associated with highest demand level achieved (P = .023). Forty-nine patients worked preoperatively, with 69.4% returning to previous employment after surgery; the average time to return to work was 1.4 months. In comparative analysis, patients who did not return to work had a higher mean body mass index (32 ± 7 vs 27 ± 5 kg/m(2); P < .008).
  
  
  CONCLUSIONS
  In this hemiarthroplasty cohort, there was a 67.2% rate of return to 1 or more sports at an average of 6.5 months postoperatively. Patients older than 65 years experienced similar improvements in ASES scores compared with patients younger than 65 years, although absolute scores were lower on average. Those who returned to higher demand sports were younger on average. Of patients working preoperatively, 69.4% returned to their previous employment at an average of 1.4 months. Patients who did not return to employment had significantly higher body mass index on average. These findings will help surgeons manage expectations of shoulder hemiarthroplasty candidates preoperatively.
authors.affiliation: Hospital for Special Surgery, New York, New York, USA garciagr@hss.edu.
authors.forename: Grant H
authors.initials: GH
authors.lastname: Garcia
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Gregory T
authors.initials: GT
authors.lastname: Mahony
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Peter D
authors.initials: PD
authors.lastname: Fabricant
authors.affiliation: University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
authors.forename: Hao-Hua
authors.initials: HH
authors.lastname: Wu
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: David M
authors.initials: DM
authors.lastname: Dines
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Russell F
authors.initials: RF
authors.lastname: Warren
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Edward V
authors.initials: EV
authors.lastname: Craig
authors.affiliation: Hospital for Special Surgery, New York, New York, USA.
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Gulotta
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods; D005260:Female; D062785:Hemiarthroplasty / Q000379:methods*; D006801:Humans; D007592:Joint Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000601:surgery; D010146:Pain / Q000601:surgery; D010147:Pain Measurement; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D000068958:Return to Sport / Q000502:physiology; D062707:Return to Work; D012785:Shoulder Joint / Q000601:surgery*; D013177:Sports / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: hemiarthroplasty; sports after surgery; work outcomes