Tuesday, August 25, 2015

Reverse total shoulder - what sports should I do after this surgery?


Outcomes of reverse total shoulder arthroplasty in a senior athletic population

These authors evaluated 41 reverse total shoulders performed in 40 patients who continued to play both low- and high-impact sports after surgery. The mean age was 73 years, and the mean follow-up period was 43 months, with a minimum of 35 months. 

Ninety-five percent of patients indicated that they were able to return to sports at the same level as before surgery or at a higher level, and only 13% reported increased pain after playing their sport after undergoing an RTSA. The overall complication rate was 7%. One zone of lucency was noted in 17% of humeral stems, with 1 case of early subsidence but no cases with loosening at final follow-up. The glenoid notching rate was 7%, with no cases of glenoid subsidence, lucency, or loosening.


The sports played by these patients are shown below.


Here is a video of a 90+ year old patient of ours playing tennis two and a half years after his right reverse total shoulder.




Comment: There is great potential for return to activities after a reverse total shoulder. What is reasonable for an individual patient needs to be determined on an individual basis by the surgeon and the patient. We need to keep in mind that the appropriateness of higher level activities depend on the technical excellence of the surgery, the quality of the patient's bone, the prior facility of the patient with the sport, and a plan for a gradual return that recognizes the great difference in bone loading with a reverse total shoulder from what the bone experienced prior to this surgery.

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