What specific activities are patients performing 2 years after primary anatomic total shoulder arthroplasty?

Background

Returning patients to their desired activities following anatomic total shoulder arthroplasty (aTSA) is an important criterion to achieve high patient satisfaction. While patients who undergo aTSA return to sports at relatively high rates, individuals’ specific desired and achieved activities following aTSA remain poorly defined.

Methods

A shoulder arthroplasty registry at a tertiary-care orthopedic hospital was reviewed retrospectively between February 1, 2016, and January 1, 2021, to identify specific patient activity and functional capabilities following aTSA at a minimum of 2 years postoperatively. Individual items and responses of the American Shoulder and Elbow Surgeons and Shoulder Activity Scale relating to activity levels, as well as free text responses pertaining to usual work and sport, were tabulated.

Results

Among 597 patients who underwent 632 primary anatomic TSAs (mean age 65.9 ± 8.3 years, 41.5% female), the median American Shoulder and Elbow Surgeons score per affected limb improved from 40.0 (interquartile range (IQR) 27.4-54.7) preoperatively to 94.9 (IQR 83.8-98.3) at 2 years (P < .001), while median Shoulder Activity Scale improved from 8.0 (IQR 5.0-12.0) preoperatively to 10.0 (6.0-14.0) at 2 years (P < .001). Two years after surgery, 78.5%, 88.6%, and 83.5% of patients were able to comb their hair, manage toileting, and put on a coat without any difficulty, respectively. A relatively small proportion of patients were able to reach a high shelf (64.7%) and lift 10 pounds above the shoulder (57.4%) without difficulty. Of the 524 (82.9%) patients who returned to recreational activities 2 years after surgery, golf (25.6%), walking (22.7%), weight training (16.8%), and swimming (15.8%) were the most commonly reported activities. Cooking and cleaning (29.9%, n = 189), desk-related work (27.2%, n = 172), yard-work or gardening (14.2%, n = 90), heavy lifting activities (6.5%, n = 41), and grocery shopping (2.5%, n = 16) were the most common forms of usual work.

Conclusion

Patients undergoing aTSA report a wide spectrum of desired recreational activities. A range of functional capabilities exists within this patient population with regards to usual sporting activity, work activity, and activities of daily living. Preoperative patient counseling may attempt to identify patients’ desired postoperative activities for more individualized education regarding their prognosis for returning to desired activities.