Return to sport after shoulder arthroplasty: a systematic review and meta-analysis.

Joseph N Liu, Michael E Steinhaus, Grant H Garcia, Brenda Chang, Kara Fields, David M Dines, Russell F Warren, Lawrence V Gulotta
Author Information
  1. Joseph N Liu: Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA. LiuJ@hss.edu.
  2. Michael E Steinhaus: Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
  3. Grant H Garcia: Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY, USA.
  4. Brenda Chang: Healthcare Research Institute, Hospital for Special Surgery, New York, NY, USA.
  5. Kara Fields: Healthcare Research Institute, Hospital for Special Surgery, New York, NY, USA.
  6. David M Dines: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
  7. Russell F Warren: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.
  8. Lawrence V Gulotta: Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA.

Abstract

PURPOSE: With increasing incidence and indications for shoulder arthroplasty, there is an increasing emphasis on the ability to return to sports. The main goal of this study was to determine the rate of return to sport after shoulder arthroplasty.
METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this systematic review and meta-analysis. A search was performed on MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the Methodological Index for Nonrandomized Studies checklist. The main judgement outcome was the rate of return to sports activity after shoulder arthroplasty and the level of play upon return (identical or higher/lower level).
RESULTS: Thirteen studies were reviewed, including 944 patients (506 athletes), treated with shoulder arthroplasty at an average follow-up of 5.1 years (range, 0.5-12.6 years). The most common sports were swimming (n = 169), golf (n = 144), fitness sports (n = 71), and tennis (n = 63). The overall rate of return to sport was 85.1% (95% CI, 76.5-92.3%), including 72.3% (95% CI, 60.6-82.8%) returning to an equivalent or improved level of play, after 1-36 months. Patients undergoing anatomic total shoulder arthroplasty returned at a significantly higher rate (92.6%) compared to hemiarthroplasty (71.1%, p = 0.02) or reverse total shoulder arthroplasty (74.9%, p = 0.003).
CONCLUSION: Most patients are able to return to one or more sports following shoulder arthroplasty, with anatomic total shoulder arthroplasty having the highest rate of return.
LEVEL OF EVIDENCE: IV.

Keywords

References

  1. J Shoulder Elbow Surg. 2015 Oct;24(10):e286-91 [PMID: 26190667]
  2. Am J Sports Med. 2015 Nov;43(11):2816-21 [PMID: 26316610]
  3. Am J Sports Med. 2010 Oct;38(10):2097-105 [PMID: 20616374]
  4. ANZ J Surg. 2003 Sep;73(9):712-6 [PMID: 12956787]
  5. Arch Orthop Trauma Surg. 1998;117(4-5):252-5 [PMID: 9581254]
  6. Knee Surg Sports Traumatol Arthrosc. 2013 Dec;21(12):2889-94 [PMID: 22644075]
  7. Am J Sports Med. 2016 Feb;44(2):490-6 [PMID: 26657261]
  8. Am J Sports Med. 2016 Mar 9;:null [PMID: 26960913]
  9. Am J Sports Med. 2008 Aug;36(8):1577-81 [PMID: 18539951]
  10. Int J Surg. 2010;8(5):336-41 [PMID: 20171303]
  11. J Shoulder Elbow Surg. 2015 Jan;24(1):91-7 [PMID: 25440519]
  12. Control Clin Trials. 1986 Sep;7(3):177-88 [PMID: 3802833]
  13. Contemp Clin Trials. 2007 May;28(3):324-8 [PMID: 17188025]
  14. BMJ. 1998 Jan 10;316(7125):140-4 [PMID: 9462324]
  15. Bull Hosp Jt Dis (2013). 2015 Dec;73 Suppl 1:S111-7 [PMID: 26631206]
  16. J Shoulder Elbow Surg. 2016 May;25(5):772-80 [PMID: 26700556]
  17. J R Stat Soc Ser A Stat Soc. 2009 Jan;172(1):21-47 [PMID: 19381328]
  18. J Shoulder Elbow Surg. 2012 Apr;21(4):554-60 [PMID: 21393018]
  19. Clin J Sport Med. 2015 Jul;25(4):338-40 [PMID: 25290106]
  20. Am J Sports Med. 2015 Feb;43(2):423-7 [PMID: 25406301]
  21. Am J Sports Med. 2007 Oct;35(10):1688-95 [PMID: 17557876]
  22. J Shoulder Elbow Surg. 2016 Jun;25(6):920-6 [PMID: 26853758]
  23. BMJ. 2003 Sep 6;327(7414):557-60 [PMID: 12958120]
  24. J Bone Joint Surg Am. 2011 Dec 21;93(24):2249-54 [PMID: 22258770]
  25. J Shoulder Elbow Surg. 1998 Jul-Aug;7(4):362-7 [PMID: 9752645]
  26. J Shoulder Elbow Surg. 2015 Sep;24(9):1481-5 [PMID: 25958214]
  27. Iowa Orthop J. 2015;35:1-7 [PMID: 26361437]
  28. J Shoulder Elbow Surg. 2014 Dec;23 (12 ):1905-1912 [PMID: 25304043]
  29. BMJ. 1997 Sep 13;315(7109):629-34 [PMID: 9310563]
  30. Bull Hosp Jt Dis (2013). 2015 Dec;73 Suppl 1:S118-23 [PMID: 26631207]
  31. J Shoulder Elbow Surg. 2011 Mar;20(2):273-80 [PMID: 20951063]
  32. J Clin Epidemiol. 2009 Jul;62(7):711-715.e1 [PMID: 19171462]
  33. J Bone Joint Surg Br. 2008 Jul;90(7):920-3 [PMID: 18591603]
  34. J Bone Joint Surg Am. 2011 Nov 16;93(22):2110-5 [PMID: 22262383]

MeSH Term

Arthroplasty, Replacement, Shoulder
Athletic Injuries
Hemiarthroplasty
Humans
Joint Diseases
Retrospective Studies
Return to Sport
Shoulder Injuries
Shoulder Joint
Treatment Outcome

Word Cloud

Created with Highcharts 10.0.0shoulderarthroplastyreturnsportsratesporttotalreviewlevelincreasingmainSystematicsystematicmeta-analysisstudiesplayincludingpatients1%95%CI3%anatomichemiarthroplastyp = 0ReturnreplacementShoulderPURPOSE:incidenceindicationsemphasisabilitygoalstudydetermineMETHODS:PreferredReportingItemsReviewsMeta-AnalysesguidelinesfollowedperformsearchperformedMEDLINEScopusEMBASECochraneLibraryqualityincludedevaluatedaccordingMethodologicalIndexNonrandomizedStudieschecklistjudgementoutcomeactivityuponidenticalhigher/lowerRESULTS:Thirteenreviewed944506athletestreatedaveragefollow-up51 yearsrange05-126 yearscommonswimmingn = 169golfn = 144fitnessn = 71tennisn = 63overall85765-9272606-828%returningequivalentimproved1-36 monthsPatientsundergoingreturnedsignificantlyhigher926%compared7102reverse749%003CONCLUSION:ableonefollowinghighestLEVELOFEVIDENCE:IVarthroplasty:Meta-analysisReverseTotal

Similar Articles

Cited By