title: Sports after shoulder arthroplasty: a comparative analysis of hemiarthroplasty and reverse total shoulder replacement.
abstract: BACKGROUND
  Traditionally, fewer postoperative sport restrictions are imposed on hemiarthroplasty (HHA) patients on than reverse total shoulder arthroplasty (RTSA) patients. However, functional outcomes have been shown to be superior in RTSA. No direct comparison of RTSA vs HHA has been done on rates of return to sports in patients with glenohumeral arthritis and rotator cuff dysfunction, proximal humeral fractures, or rheumatoid arthritis.
  
  
  METHODS
  This is a retrospective review of consecutive RTSA and HHA patients collected from our institution's shoulder arthroplasty registry. All patients playing sports preoperatively with minimum 1-year follow-up were included. Final follow-up included an additional patient-reported questionnaire with questions regarding physical fitness and sport activities.
  
  
  RESULTS
  The study included 102 RTSA and 71 HHA patients. Average age at surgery was 72.3 years for RTSA compared with 65.6 years for HHA (P < .001). Patients undergoing RTSA had improved visual analog scale scores compared with HHA (-5.6 vs -4.2, P = .007), returned to sports after RTSA at a significantly higher rate (85.9% vs 66.7%, P = .02), and were more likely to be satisfied with their ability to play sports (P = .013). HHA patients were also more likely to have postoperative complaints than RTSA patients (63% vs 29%, P < .0001). No sports-related complications occurred. Female sex, age <70 years, surgery on the dominant extremity, and a preoperative diagnosis of arthritis with rotator cuff dysfunction predicted a higher likelihood of return to sports for patients undergoing RTSA compared with HHA.
  
  
  CONCLUSIONS
  Despite traditional sport restrictions placed on RTSA, patients undergoing RTSA can return to sports at rates higher than those undergoing HHA, with fewer postoperative complaints.
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA. Electronic address: LiuJ@hss.edu.
authors: Joseph N
authors: JN
authors: Liu
authors: Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY, USA.
authors: Grant H
authors: GH
authors: Garcia
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors: Gregory
authors: G
authors: Mahony
authors: Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
authors: Hao-Hua
authors: HH
authors: Wu
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors: David M
authors: DM
authors: Dines
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors: Russell F
authors: RF
authors: Warren
authors: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
authors: Lawrence V
authors: LV
authors: Gulotta
mesh_terms: D000328:Adult; D000368:Aged; D001168:Arthritis / Q000601:surgery*; D001172:Arthritis, Rheumatoid / Q000601:surgery; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods*; D005260:Female; D062785:Hemiarthroplasty; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012189:Retrospective Studies; D000068958:Return to Sport; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries / Q000601:surgery; D012784:Shoulder Fractures / Q000601:surgery; D000070599:Shoulder Injuries; D012785:Shoulder Joint / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
keywords: Reverse total shoulder arthroplasty; hemiarthroplasty; physical fitness; return to activity; shoulder replacement; sports