Thursday, May 25, 2017

Return to work after humeral hemiarthroplasty and reverse total shoulder arthroplasty

A comparative analysis of work-related outcomes after humeral hemiarthroplasty and reverse total shoulder arthroplasty

These authors conducted a review of patients who underwent a reverse total shoulder (RTSA, N = 40) or  or humeral hemiarthroplasty.

Inclusion criteria were a preoperative diagnosis of endstage glenohumeral arthritis with rotator cuff dysfunction, deficiencies in glenoid bone stock that prohibited the insertion of an anatomic glenoid component, proximal humerus fracture, and minimum of 1-year follow-up. The study included patients who underwent revision or bilateral procedures. The study excluded patients with other preoperative diagnoses, patients with <1-year follow-up, and patients who had not worked within 3 years preoperatively. 

 Postoperatively, 65% of RTSA patients returned to work compared with 70.7% of HHA patients (P = .64). 

Comment: The choice of type of arthroplasty among the wide range of diagnoses and patients in this series was highly individualized by the surgeon and the patient. The two groups are not likely to be comparable without controlling for the many variables that affect the result.

However, what is of interest in this paper is the surgeons' success in achieving a high percentage of patients that were able to return to work after their surgery - especially considering the average age of the patients. Individuals are working later in their lives and those considering shoulder surgery are interested in knowing whether a return to work is likely. This study provides relevant information for each of these two procedures.

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