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. Purpose: To determine the rate of return to sports in patients aged ≤55 years unde...

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Publicado en:American Journal of Sports Medicine Vol. 45; no. 7; pp. 1664 - 1670
Autores principales: Garcia, Grant H., Liu, Joseph N., Sinatro, Alec, Dines, Joshua S., Warren, Russell F., Dines, David M., Gulotta, Lawrence V., Wu, Hao-Hua
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. Jun2017
Acceso en línea:Ver este registro en EBSCOhost
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      jtl: American Journal of Sports Medicine
      issn: 03635465
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      dt: Jun2017
      vid: 45
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      pub: Sage Publications Inc.
      place: Thousand Oaks, California
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        atl: High Satisfaction and Return to Sports After Total Shoulder Arthroplasty in Patients Aged 55 Years and Younger.
      aug:
        au:
          Garcia, Grant H.
          Liu, Joseph N.
          Sinatro, Alec
          Dines, Joshua S.
          Warren, Russell F.
          Dines, David M.
          Gulotta, Lawrence V.
          Wu, Hao-Hua
        affil: Hospital for Special Surgery, New York, New York, USA
      sug:
        subj:
          Arthroplasty, Replacement, Shoulder In Middle Age
          Sports Re-Entry In Middle Age
          Human
          New York
          Middle Age
          Retrospective Design
          Record Review
          Prospective Studies
          Osteoarthritis Surgery
          Functional Assessment
          Visual Analog Scaling
          Clinical Assessment Tools
          Young Adult
          Adult
          Patient Satisfaction Evaluation
          Questionnaires
          Paired T-Tests
          Logistic Regression
          Fisher's Exact Test
          Two-Tailed Test
          P-Value
          Data Analysis Software
          Male
          Female
          Descriptive Statistics
          Middle Aged: 45-64 years
          Adult: 19-44 years
          Male
          Female
      ab: 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. Purpose: To determine the rate of return to sports in patients aged ≤55 years undergoing TSA. Study Design: 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. Conclusion: 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.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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