High Satisfaction and Return to Sports After Total Shoulder Arthroplasty in Patients Aged 55 Years and Younger.
BACKGROUND
Young, active candidates for total shoulder arthroplasty (TSA) are a unique group of patients. Not only do they demand longevity and improved function, but they also desire a return to physical activities.


OBJECTIVE
To determine the rate of return to sports in patients aged ≤55 years undergoing TSA.


METHODS
Case series; Level of evidence, 4.


METHODS
This was a retrospective review of consecutive patients who underwent anatomic TSA at a single institution. Exclusion criteria included age at the time of surgery >55 years and <2 years of follow-up. All patients had end-stage osteoarthritis with significant glenohumeral joint space narrowing. The final follow-up consisted of a patient-reported sports questionnaire, American Shoulder and Elbow Surgeons (ASES) score, and visual analog scale (VAS) score.


RESULTS
From 70 eligible patients, 59 patients (61 shoulders) were included with an average follow-up of 61.0 months (range, 25-103 months) and average age at the time of surgery of 48.9 years (range, 25-55 years). The average VAS score improved from 5.6 to 0.9 ( P < .001), and the average ASES score improved from 39.3 to 88.4 ( P < .001). Forty-nine procedures (80.3%) were performed for a primary diagnosis of osteoarthritis. Four shoulders returned to the operating room; none were for glenoid loosening. There was a 93.2% satisfaction rate, and 67.7% of patients (n = 40) stated that they underwent their surgery to return to sports. Moreover, patients in 96.4% of shoulders (55/57) restarted at least 1 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 (77.7%), basketball (75.0%), and flag football (66.7%). Patients in 47 shoulders (82.4%) returned to a similar or higher level of sports; 90.3% returned to high-demand sports, and 83.8% returned to high upper extremity sports. There was no significant difference in rates of return to sports by body mass index, sex, age, preoperative diagnosis, revision status, and dominant extremity.


CONCLUSIONS
In patients aged ≤55 years undergoing TSA, there was a 96.4% rate of return to ≥1 previous sports at an average of 6.7 months. Furthermore, at an average follow-up of 61.0 months, no patients needed revision of their glenoid component, despite an 83.8% rate of return to high upper extremity sports. While caution should still be advised in young, active patients undergoing TSA, these results demonstrate a high satisfaction rate and improved ability to return to most sports after surgery.
Hospital for Special Surgery, New York, New York, USA.
Grant H
GH
Garcia
Hospital for Special Surgery, New York, New York, USA.
Joseph N
JN
Liu
Hospital for Special Surgery, New York, New York, USA.
Alec
A
Sinatro
University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Hao-Hua
HH
Wu
Hospital for Special Surgery, New York, New York, USA.
Joshua S
JS
Dines
Hospital for Special Surgery, New York, New York, USA.
Russell F
RF
Warren
Hospital for Special Surgery, New York, New York, USA.
David M
DM
Dines
Hospital for Special Surgery, New York, New York, USA.
Lawrence V
LV
Gulotta
D000328:Adult; D000367:Age Factors; D000072228:Arthroplasty, Replacement, Shoulder; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000473:pathology / Q000601:surgery*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D000068958:Return to Sport; D012785:Shoulder Joint / Q000473:pathology / Q000601:surgery*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
active; glenoid component; sports; total shoulder arthroplasty; young