Outcomes of reverse total shoulder arthroplasty in a senior athletic population

Simovitch, Ryan W.; Gerard, Berenice K.; Brees, Jordon A.; Fullick, Robert K; Kearse, Justin C.

doi:10.1016/j.jse.2015.03.011

Cited by 58 publications

(73 citation statements)

References 21 publications

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“…Although several studies have demonstrated the ability of patients to return to sports following TSA, 8,[14][15][16][17][18] a limited number of studies discuss the return to sports following RSA. [19][20][21] Despite known postoperative improvements, no clear consensus is reached as to which specific sports patients can return to and at what level of participation is to be expected. Surveyed members of the American Shoulder and Elbow Surgeons (ASES) universally favored full return to sports, except for contact sports for TSA patients, whereas other surgeons are more conservative to allow RSA patients to return to activities.…”

Section: Take-home Pointsmentioning

confidence: 99%

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Kurowicki

Rosas²,

Law³

et al. 2018

Am J Orthop

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Both anatomical total shoulder arthroplasty (TSA) and reverse shoulder arthroplasty (RSA) are routinely performed for patients who desire to continuously work or participate in sports. This study analyzes and compares the ability of patients to work and partake in sports following shoulder arthroplasty based on responses to clinical outcome surveys. A retrospective review of the shoulder surgery repository was performed for all patients treated with TSA and RSA and who completed questions 9 and 10 on the activity patient self-evaluation portion of the American Shoulder and Elbow Surgeons (ASES) Assessment Form. Patients with a minimum of 1-year follow-up were included if a sport or work was identified. The analysis included 162 patients with TSA and 114 patients with RSA. Comparisons were made between TSA and RSA in terms of the specific ASES scores (rated 0-3) reported for ability to work and participate in sports and total ASES scores, and scores based on specific sports or line of work reported. Comparisons were also made between sports predominantly using shoulder function and those that do not. TSA patients had a 27% higher ability to participate in sports (average specific ASES score: 2.5 vs 1.9, P < .001) than RSA patients and presented significantly higher scores for swimming and golf. Compared with RSA patients, TSA patients demonstrated more ability to participate in sports requiring shoulder function without difficulty, as 63% reported maximal scores (P = .003). Total shoulder arthroplasty patients also demonstrated a 21% higher ability to work than RSA patients (average specific ASES scores: 2.6 vs 2.1, P < .001), yielding significantly higher scores for housework and gardening. Both TSA and RSA allow for participation in work and sports, with TSA patients reporting better overall ability to participate. For sports involving shoulder function, TSA patients more commonly report maximal ability to participate than RSA patients.

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Section: Take-home Pointsmentioning

confidence: 99%

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Kurowicki

Rosas²,

Law³

et al. 2018

Am J Orthop

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“…Auch ein direkter Vergleich zwischen Hemiarthroplastik (n = 71,66 Jahre) und inverser TEP (n = 102,72 Jahre) deckte eine deutliche Unterlegenheit der Hemiprothesen auf [65] [67]. Eine Reihe weiterer Studien aus den vergangenen 2 Jahren bestätigt die eher unerwartet gute Sportfähigkeit mit inversen Prothesen im kurz- bis mittelfristigen Verlauf mit bis zu über 90 % allgemeiner Rückkehrquote und 20-25 % Rückkehrquote sogar in High-impact-Sportarten binnen etwa 6 Monaten post-OP ohne erhöhte Komplikationsraten [68][69][70]. Für anatomische TEPs auf dem Boden einer primären Omarthrose konnten Bülhoff et al anhand einer Kohorte von n = 154 Patienten, stratifiziert nach präoperativer sportlicher Aktivität zeigen, dass 100 % der prä-OP aktiven Patienten (n = 105) auch post-OP wieder sportlich aktiv waren, während prä-OP inaktive Patienten (n = 49) auch post-OP sehr wahrscheinlich inaktiv bleiben [71].…”

Section: Schulterendoprothetik: Allgemeine Sportfähigkeitunclassified

Endoprothetischer Gelenkersatz und Sport

Oehler

Schmidt

Niemeier

2017

Phys Med Rehab Kuror

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Zusammenfassung Hintergrund Es finden sich zunehmend Patienten mit sportlichem Funktionsanspruch, für die nicht nur die Frage nach grundsätzlicher Sportfähigkeit nach Endoprothesenimplantation, sondern auch nach dem erreichbaren Sportniveau im Sinne der Rückkehr zu präoperativer sportlicher Aktivität bedeutsam ist. Dieser Artikel soll einen Überblick über neuere Daten zu folgenden Fragen hinsichtlich Hüft-, Knie und Schulterendoprothetik geben: (1) Welche Auswirkungen hat sportliche Aktivität auf Endoprothesen? (2) Welches Sportniveau ist nach endoprothetischer Versorgung erreichbar? (3) Welche Empfehlungen können zu sportlicher Aktivität mit Endoprothese gegeben werden? Methoden PubMed basierte Literaturrecherche. Narrativer Review mit Fokus auf aktuellen Daten aus den Jahren 2010–2016. Ergebnisse Die allgemein bekannte Empfehlung zu Low-impact-Sportarten mit moderater Intensität wie Wandern, Schwimmen, Radfahren, Golfbehält ihre Gültigkeit für sämtliche Prothesentypen an allen Gelenken. Hier ist unstrittig, dass die positiven die negativen Effekte überwiegen. Nach Implantation von HTEP und KTEP findet die Mehrheit der prä-OP aktiven Patienten nach 3–6 Monaten wieder zu sportlicher Aktivität zurück, wenn auch mit klarer Tendenz zu niedrigerer Intensität und einer Verschiebung von high impact hin zu low impact. Wichtige offene Fragen beziehen sich auf die Effekte von mit hoher Intensität betriebenen Low-impact-Sportarten, auf High-impact-Sportarten, auf sportartspezifische Wirkungen sowie auf prothesentypspezifische Möglichkeiten. Hier sind die Grenzen zwischen positiven und negativen Effekten von sportlicher Belastung unterschiedlicher Intensität erst beginnend untersucht. Neue Daten weisen darauf hin, dass allgemein eine höhere sportliche Leistungsfähigkeit erreichbar ist, als traditionell empfohlen wird. Frühe Ergebnisse unikondylärer Knieprothesen übertreffen die bikondylärer Prothesen deutlich. Schulterendoprothesen zeigen entgegengesetzt zu Expertenempfehlungen die höchsten postoperativen Aktivitätslevel nach inverser und anatomischer TEP und die geringste Sportaktivität nach Hemiprothesen. Schlussfolgerung Bisherige Expertenempfehlungen und faktische Möglichkeiten des Sportniveaus nach Endoprothesenimplantation divergieren z. T. erheblich. Es bleibt durch zukünftige Studien zu definieren, welches Sportniveau unter Verwendung moderner abriebarmer Gleitpaarungen und Prothesendesigns in welcher Sportart mit welcher Prothese ein positives Nutzen-Risiko-Verhältnis darstellt.

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“…In an evaluation of RTSA in a senior athletic population, Simovitch et al[ 41 ] reported that 60% (40 of 67) patients who participated in a sport preoperatively returned to sports after surgery. Of the patients that resumed sports postoperatively, 12 patients (30%) indicated that they were able to perform their activities at a higher level, and 26 patients (65%) reported no change in performance.…”

Section: Return To Sport After Reverse Tsamentioning

confidence: 99%

“…Glenohumeral HA is well established as a method to treat glenohumeral arthritis and complex three- and four-part proximal humerus fractures[ 42 ]. With its low failure rate, HA has traditionally been considered a safer option than total or reverse total shoulder replacements for patients who wish to remain active[ 41 ]. Other advantages of HA over these other prostheses include a less technically demanding procedure and shorter operative time[ 43 ].…”

Section: Return To Sport After Hamentioning

confidence: 99%

Return to sports after shoulder arthroplasty

Johnson¹,

Johnson²,

Liu³

et al. 2016

WJO

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Many patients prioritize the ability to return to sports following shoulder replacement surgeries, including total shoulder arthroplasty (TSA), reverse total shoulder arthroplasty (RTSA), and hemiarthroplasty (HA). While activity levels after hip and knee replacements have been well-established in the literature, studies on this topic in the field of shoulder arthroplasty are relatively limited. A review of the literature regarding athletic activity after shoulder arthroplasty was performed using the PubMed database. All studies relevant to shoulder arthroplasty and return to sport were included. The majority of patients returned to their prior level of activity within six months following TSA, RTSA, and shoulder HA. Noncontact, low demand activities are permitted by most surgeons postoperatively and generally have higher return rates than contact sports or high-demand activities. In some series, patients reported an improvement in their ability to participate in sports following the arthroplasty procedure. The rates of return to sports following TSA (75%-100%) are slightly higher than those reported for HA (67%-76%) and RTSA (75%-85%). Patients undergoing TSA, RTSA, and shoulder HA should be counseled that there is a high probability that they will be able to return to their preoperative activity level within six months postoperatively. TSA has been associated with higher rates of return to sports than RTSA and HA, although this may reflect differences in patient population or surgical indication.

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Outcomes of reverse total shoulder arthroplasty in a senior athletic population

Cited by 58 publications

References 21 publications

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Participation in Work and Sport Following Reverse and Total Shoulder Arthroplasty

Endoprothetischer Gelenkersatz und Sport

Return to sports after shoulder arthroplasty

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