The body mass index (BMI) is commonly used to indicate whether a person is underweight or overweight:
Metric units: BMI = weight (kg) ÷ [height (m)]²
U.S. units: BMI = 703 × weight (lb) ÷ [height (in)]²
For example, a person 5 feet 10 inches (70 inches) tall who weighs 200 lb has a BMI of 703 × 200 ÷ 70² = 28.7.
Category | BMI |
Underweight | below 18.5 |
Healthy (normal) weight | 18.5–24.9 |
Overweight | 25.0–29.9 |
Class I obesity | 30.0–34.9 |
Class II obesity | 35.0–39.9 |
Class III obesity | 40 or more |
Patients with a high BMI often ask whether their weight will compromise their result after shoulder arthroplasty. Some ask because they have been told they must lose weight before a hip or knee arthroplasty. Some health systems and surgeons use BMI cutoffs of 35 or 40 kg/m² to decide who may have an elective hip or knee replacement. No such formal policy exists for the shoulder; does hip and knee thinking apply to the shoulder?
A recent Perspectives article in JBJS by Setor Kunutsor asks whether an “obesity paradox” applies to the shoulder [1]. The article is built around the UK and Danish registry study by Valsamis et al. [2]. The paradox is the observation that, among patients with heart failure, coronary disease, kidney disease and other conditions, those with overweight or moderate obesity survive longer than those of normal weight. Here we put that study together with the rest of the shoulder literature and ask a simple question: what does a patient’s BMI tell us about what will happen after shoulder arthroplasty?
The short answer
The relationship is not a straight line. Underweight patients (BMI <18.5) have more deaths, more complications and more revisions. Patients with obesity have more blood clots and readmissions, and more periprosthetic joint infections, which often appear months after surgery; the risk of periprosthetic infection rises sharply above a BMI of 40. But patients with obesity do not die more often, and their improvement in comfort and function is about the same as that of patients with normal weight.
A larger point runs through all of these studies: BMI may be standing in for something else. The difference between a patient with a high BMI who is strong and active and a patient with a low BMI who is frail and malnourished may relate more to fitness than to weight. None of the shoulder studies measured fitness, so we cannot yet say how much of the BMI effect is really a fitness effect.
Outcome | What the studies show | Strength of evidence |
90-day and 1-year mortality | Not higher with increasing BMI; lower at 1 year with high BMI. Higher in underweight patients. | Two national registries, 20,766 procedures, but few deaths; older U.S. series agree [2–5] |
Complications in the first 30 days (including early wound infection) | Higher in underweight patients; not higher in patients with obesity. | Large NSQIP analyses [6,7] |
Blood clots and readmission (90 days) | Higher in patients with obesity; higher with increasing BMI. | Large claims-database study [8] |
Periprosthetic joint infection (90 days to 2 years) | Higher in patients with obesity; at 2 years, 2.7 times higher at BMI ≥40 than at BMI 19–39. | Large claims-database studies [8,9] |
Revision | Conflicting. Higher in older and unadjusted data; no difference after matching in recent cohorts. Higher with class III obesity after rTSA for fracture. | Registries and cohorts that disagree [2,8,10–13] |
Patient-reported outcomes | Patients with obesity improve substantially; differences from patients without obesity are less than the MCID. | Two cohorts and a meta-analysis [11,12,14] |
The figure below sketches how these risks appear to change with BMI.
Figure. Approximate risk relative to normal weight across the range of BMI. This is a schematic, not a fitted model: the curves were drawn by hand to pass through published estimates and should be read for their shape, not their exact values. Several limitations apply. The estimates come from different studies with different populations, outcome definitions and follow-up periods (30 days to two years). The blue curve combines mortality and medical complications, which do not behave identically; the underweight end is based on small numbers, and the curve above a BMI of 40 is especially uncertain because few patients and few events lie there. The rise in infection between BMIs of 35 and 40 is smoothed: Parel et al. reported a step, with similar risk from 19 to 39 and 2.7 times the risk at 40 or more. Revision is not shown because the studies conflict and the risk depends on the procedure and diagnosis. All of the underlying data are observational, so the curves describe association, not cause, and they say nothing about the comfort and function patients gain from surgery.
What has been demonstrated
Underweight patients. In National Surgical Quality Improvement Program (NSQIP) data on 15,717 total shoulder arthroplasties (2005–2016), underweight patients had higher odds of any adverse event (OR 2.22), a serious adverse event (OR 3.18) and postoperative infection (OR 2.77) within 30 days than normal-weight patients [6]. No higher BMI category differed from normal weight in this 30-day window. This is not in conflict with the higher infection risk in patients with obesity described below. Ottesen’s “postoperative infection” combined superficial and deep wound infection, urinary tract infection and sepsis, and counted only events in the first 30 days (1.8% of patients). Periprosthetic infection after shoulder arthroplasty, often from Cutibacterium, commonly becomes evident months later; studies that followed patients to 90 days and 2 years found more periprosthetic infection with obesity [8,9]. In the UK registry data, compared with a BMI of 21.75, a BMI of 18.5 was associated with higher 90-day mortality (HR 1.69), more 90-day serious adverse events (OR 1.36) and more revision (HR 1.70) [2]. Only 131 UK and 70 Danish patients were underweight, and the authors limit this finding to the UK data. Two other NSQIP analyses also found higher mortality in patients with low BMI [5,15].
Mortality. Valsamis et al. studied 20,766 elective primary shoulder arthroplasties: 15,320 from the UK National Joint Registry (2018–2022) and 5,446 from the Danish Shoulder Arthroplasty Registry (2006–2021) [2]. They adjusted for age, sex, deprivation, indication and ASA score. In the UK data, a BMI of 40 was associated with lower mortality at one year than a BMI of 21.75 (HR 0.40), and the Danish data showed a similar pattern. Higher BMI was not associated with more serious adverse events or more revision. Death is rare after this surgery: there were 136 deaths within a year in the UK data and 101 in the Danish data, so the estimates at the extremes of BMI rest on few events. Older U.S. series found either no association between obesity and mortality or lower mortality in patients with obesity [3–5].
Infection, thromboembolism and readmission. Cogan et al. identified 113,634 patients having anatomic or reverse arthroplasty in the PearlDiver insurance-claims database and compared patients with and without obesity, matched 1:1 for age, sex, diabetes, smoking and Charlson Comorbidity Index [8]. Patients with obesity had higher odds of readmission, deep venous thrombosis, pulmonary embolism, superficial infection and periprosthetic joint infection within 90 days, and complication rates rose with BMI. Parel et al. studied 10,901 patients and found that those with a BMI of 40 or more had 2.7 times the risk of periprosthetic joint infection at two years (95% CI 1.4–5.3) [9]. The confidence interval is wide, but the direction is clear. Neither study found a difference in 90-day major complications after matching.
Revision. Here the studies disagree. The Mayo Clinic registry of 4,567 shoulder arthroplasties (1970–2013), which included hemiarthroplasties, found that the risk of revision rose 5% for each unit of BMI, along with more revision for mechanical failure and more superficial infection [10]. A meta-analysis of unadjusted data found higher odds of dislocation (OR 2.49), fracture (OR 1.92) and revision (OR 1.49) in patients with obesity [11]. In contrast, the matched claims-database cohort found no increase in mechanical complications or revision at two years [8], the UK/Danish registries found no increase in revision up to 4.5 years [2], and a single-institution series of 466 patients found similar 10-year implant survival across BMI groups [12]. The Australian registry (2015–2022) helps sort this out [13]. Class III obesity (BMI ≥40) was associated with more all-cause revision (HR 1.87) and more revision for instability or dislocation (HR 2.84) after reverse total shoulder arthroplasty (rTSA) for fracture. Class I and II obesity were associated with more revision for cuff insufficiency after anatomic total shoulder arthroplasty (aTSA) for osteoarthritis (HR 2.30 and 2.10). All-cause revision did not differ by BMI after aTSA for osteoarthritis or rTSA for cuff tear arthropathy. The risk appears to depend on the diagnosis and the procedure, not on BMI alone.
What matters most to patients. Reid et al. studied 1,520 aTSAs and 2,054 rTSAs with a mean follow-up of five years [14]. Patients with obesity had more pain and less motion both before and after surgery, and somewhat lower ASES and SPADI scores after surgery. Both groups improved substantially, and none of the differences between groups reached the minimal clinically important difference (MCID). In the single-institution series, SANE, SST, pain and ASES scores did not differ by BMI at a mean of 4.5 to 5.8 years [12]. The meta-analysis found that patients with obesity had about 10° less forward flexion and slightly more pain, a pain difference the authors judged not clinically relevant [11]. Reid’s data come from a single manufacturer’s multi-institutional registry of one implant system, with a manufacturer employee among the authors; we would like to see the same question answered in independent data. In the meantime, a patient with obesity can expect about the same benefit from the surgery as a patient without it.
What has been inferred: it may be fitness, not weight
Kunutsor’s central argument is that BMI is a poor proxy for what actually determines how a patient tolerates surgery [1]. BMI does not distinguish fat from muscle, and it says nothing about cardiorespiratory fitness, strength, function or frailty. Outside orthopaedics, there is strong evidence that cardiorespiratory fitness predicts survival at every level of body fat, and that fit people with obesity can do better than unfit people of normal weight [1]. He suggests that this may explain much of the obesity paradox.
Seen this way, the shoulder data make sense. Patients with a higher BMI often carry more lean muscle and more physiologic reserve. Underweight patients often carry the opposite: sarcopenia, frailty, malnutrition, osteopenia or undiagnosed chronic disease [1,2]. Low BMI may be less a cause of poor outcomes than a sign of a patient with little reserve. Recovery after shoulder arthroplasty depends on upper-limb strength, the ability to get off the toilet or out of bed without using the arms, neuromuscular control and the ability to carry out rehabilitation, not on tolerance of weight-bearing, so muscle and fitness may matter even more here than at the hip or knee. Valsamis et al. add that the shoulder does not usually bear body weight, so the humeral and glenoid components may not see the mechanical load that loosens lower-limb implants in patients with a high BMI [2].
If BMI is a poor measure of reserve, what is better? In 10,527 shoulder arthroplasties, Fu et al. compared how well simple patient variables and comorbidity indices discriminated between patients who did and did not have adverse events [16]. BMI performed no better than chance (area under the curve 0.49–0.55). Age (0.59–0.73), ASA class (0.58–0.63) and the modified frailty index (0.57–0.62) did better, though none discriminated strongly. In 18,957 total shoulder arthroplasties, Traven et al. found that the five-item modified frailty index predicted serious medical complications, readmission, discharge to a facility and mortality; the odds of death roughly doubled with each point on the index (OR 2.11) [17]. But the frailty index is not a measure of fitness either. Four of its five items are diagnoses (diabetes, congestive heart failure, COPD and hypertension); only the fifth, functional dependence, says anything about what the patient can do. It measures accumulated disease rather than physical reserve. Direct measures of reserve, such as gait speed, grip strength, a timed chair-stand or a six-minute walk, are simple to obtain in clinic but have not been studied as predictors of outcome after shoulder arthroplasty; the Timed Up and Go test and gait speed have been used only to screen for fall risk before surgery [20].
The fitness explanation remains a hypothesis. None of the shoulder studies measured fitness, strength, body composition or frailty; the closest any came was adjusting for ASA score or a comorbidity index. Until these are measured, we cannot say whether fitness explains the BMI findings, only that it is a plausible explanation the data cannot exclude.
Falls
What has been demonstrated. Falls are common after shoulder arthroplasty. Sridharan et al. followed 198 patients for 90 days after anatomic or reverse total shoulder arthroplasty or hemiarthroplasty; 10.6% fell after discharge from the hospital [18]. More than half of these falls occurred in the first six weeks, while the patient was wearing a sling. Of the 21 outpatient falls, 5 led to an emergency department visit, 4 to readmission and 4 to an injury elsewhere in the body; 1 caused a periprosthetic humeral fracture. Female sex (aOR 4.79), a longer hospital stay and a history of a movement disorder such as Parkinson’s disease or stroke (aOR 7.20) were independent risk factors. In the Nationwide Inpatient Sample, the rate of falls in the hospital after shoulder arthroplasty rose from 0% in 2002 to 1.7% in 2011, even as hospital stays became shorter [19]. Many patients are at risk before surgery. Kaiser et al. timed 198 patients on the Timed Up and Go test before elective shoulder surgery, excluding patients with a movement disorder or unexplained falls [20]. A time of more than 14 seconds, which indicates high fall risk, was recorded in 29% of the 80 patients scheduled for total shoulder arthroplasty and in 12% of the 118 scheduled for rotator cuff repair. In the Mayo Clinic registry, the risk of periprosthetic fracture decreased as BMI increased [10].
What has been inferred. None of the BMI studies recorded falls. Yet the patients most likely to fall are the same patients the BMI data identify as high risk: the underweight, the frail and those with little muscle. These patients are also the most likely to have osteopenic bone, so a fall that a stronger patient would walk away from may fracture the humerus around the humeral component, dislocate a reverse total shoulder arthroplasty or disrupt the subscapularis repair. The surgery adds to the risk for a time. The sling takes away the arm the patient would use to catch a fall or steady himself or herself, and anesthesia, opioids and poor sleep impair balance in the first weeks. A patient who must push up with the arms to rise from a chair or a toilet will have only one arm to push with. Severe obesity can also make rising and walking harder, so the question is the same at either end of the BMI range: can this patient move about safely with one arm in a sling? A single fall can undo an otherwise excellent arthroplasty.
The Timed Up and Go test
How it is done. The Timed Up and Go (TUG) test takes about a minute in clinic and needs only a chair, a stopwatch and a line on the floor 3 meters (10 feet) away. The patient sits back in a standard armchair, wearing his or her usual shoes and using any usual walking aid. On the word “Go,” the patient stands up, walks to the line at a normal pace, turns, walks back and sits down; timing stops when the patient is seated again [21]. The examiner stays beside the patient and watches for a slow, tentative pace, loss of balance, short or shuffling steps, steadying on the walls and turning en bloc [21]. In a patient facing shoulder arthroplasty, we also note whether he or she must push up with the arms to stand.
How to read the result. In healthy older adults, the average time is 8.1 seconds at 60 to 69 years, 9.2 seconds at 70 to 79 years and 11.3 seconds at 80 to 99 years [22]. The CDC considers a time of 12 seconds or more to indicate risk of falling [21]; Shumway-Cook et al. proposed 13.5 seconds [23], and Kaiser et al. used 14 [20]. A slow time is a reason to look further, not a verdict: a meta-analysis found that the TUG alone has limited ability to predict falls in community-dwelling older adults [24]. We combine it with questions about prior falls, dizziness, medications and whether the patient feels unsteady.
Why we should be careful with these data
All of these studies are observational. Several features of the data deserve attention before we draw firm conclusions.
• Surgeons make the choice. Registries include only the patients with obesity whom a surgeon judged fit for surgery. If surgeons declined the sickest patients with obesity, those who were operated on are healthier than patients with obesity in general, and weight can look “protective.” Valsamis et al. acknowledge this, and add that patients with obesity and a failed arthroplasty may have been judged unfit for revision, which would make their revision rate look falsely low [2].
• BMI is a crude measure. It does not distinguish muscle from fat, and it says nothing about fitness, frailty or function. The variable we most want to know about was not recorded in any of these studies.
• Missing data. BMI was missing for 30.5% of the UK procedures and 46.4% of the Danish procedures [2]. The authors found similar demographics in patients with and without BMI data and treated the missing values as random. That is reasonable, but it is an assumption.
• No difference is not the same as no effect. A finding that higher BMI was not significantly associated with revision does not prove that BMI has no effect on revision, particularly in small subgroups such as class III obesity.
• The outcomes measured are not the ones patients ask about. The large registry studies report mortality, serious adverse events and revision. Valsamis et al. could not analyze patient-reported outcomes because the UK registry’s data were too incomplete [2]. Revision is a surrogate: a patient with a poor result who is not revised can be counted as a success.
Taken together, these limits mean that the data argue against BMI cutoffs for shoulder arthroplasty, but they do not prove that weight is irrelevant.
Shoulder arthroplasty for arthritis is not an emergency
Arthroplasty for a proximal humeral fracture must be scheduled within days or weeks. Arthroplasty for arthritis does not. A patient who has lived with an arthritic shoulder for years can take weeks or months to prepare, and that time is well spent. The BMI studies did not examine the timing of surgery, but the patients at highest risk in them, the underweight, the frail and the deconditioned, are the patients with the most to gain from preparation. We ask each patient to come to the operating room as healthy and as well prepared as possible, and we provide a written guide, How you can optimize your surgical outcome! In brief:
• Nutrition. Many patients come to surgery undernourished without realizing it, including some who are not underweight. We recommend about 0.5 gram of protein per pound of body weight per day, one to three nutritional supplement drinks (such as Ensure Plus) per day in the weeks before and after surgery, and asking the primary care provider about vitamin D and vitamin C. For a patient who is underweight or has been losing weight, we look for the cause and check bone health.
• Recent weight loss and GLP-1 medications. A patient who has lost weight, including on a GLP-1 medication such as semaglutide or tirzepatide, should tell us: his or her current weight and nutritional reserve may differ from the record, and part of the weight lost may be muscle. These drugs also slow emptying of the stomach. At the University of Washington, a patient who has taken a GLP-1 medication within five weeks of surgery takes only clear liquids for the 24 hours before surgery.
• Fitness. At least 30 minutes of activity each day: walking, plus simple strengthening such as step-ups, and balance practice. We ask the patient to practice getting out of a chair, out of bed and off the toilet without using the arms, because after surgery he or she will have only one arm to use. A few months of this conditioning may help the patient more than a few pounds of weight loss.
• Habits. Stopping smoking and nicotine at least a month before surgery and alcohol at least two weeks before, and reducing opioid use in a plan made with the provider who prescribes it.
• Home safety and daily activities. Good lighting on stairs and along the path to the bathroom; removing clutter, loose rugs and cords; railings on stairs and grab bars; up-to-date glasses; a non-slip mat, shower chair and handheld showerhead; front-opening tops and slip-on shoes that can be managed with one arm; transportation, since many patients should not drive for up to six weeks; and help at home arranged and on the calendar before surgery, especially for a patient who lives alone.
• Medications. Reviewing sedatives, sleeping pills and blood-pressure medications that cause lightheadedness, and planning to keep opioid use after surgery to a minimum.
• Chronic conditions and a primary care provider. Every patient should have a primary care provider who knows him or her before surgery: to optimize blood sugar (we recommend an A1C below 7), blood pressure, lung function and bone health; to treat skin and dental problems; to evaluate dizziness, balance problems and prior falls; and to be available after surgery for problems that are not about the shoulder. A patient without one should establish care before surgery is scheduled.
What we tell our patients
• Weight alone should not keep a patient from shoulder arthroplasty. We judge candidacy on the patient’s overall health, fitness, function and goals.
• Shoulder arthroplasty for arthritis is not an emergency. We take the time before surgery to improve nutrition, fitness and home safety, and to make sure the patient has a primary care provider.
• We ask about fitness directly: how far the patient walks, how many stairs he or she climbs, whether he or she exercises, and whether he or she can get out of a chair, bed or toilet without pushing up with the arms. These answers may tell us more than the scale.
• Patients with a BMI of 40 or more should know that their risk of infection, blood clots and readmission is higher. We work with them and their physicians on diabetes control, smoking cessation and prophylaxis against thromboembolism.
• Patients with class III obesity who need rTSA for a fracture should be told that their risk of instability and revision is higher.
• Underweight patients are an under-recognized high-risk group. We check nutrition, bone health, muscle mass and possible underlying illness before surgery.
• We ask every patient about falls, dizziness and balance, and we plan for the weeks in the sling. A fall in those weeks can undo the arthroplasty.
• Patients with obesity can expect about the same improvement in comfort and function as other patients.
Looking forward
The question that matters to a patient is not only whether BMI predicts revisions or complications, but whether he or she will be able to sleep, reach and work after surgery, and whether that benefit lasts. Answering it will take studies that measure fitness, strength, body composition, frailty and falls, rather than BMI alone, along with patient-reported outcomes before surgery and at long-term follow-up, and that account for the patients who are lost along the way. If fitness rather than weight is what matters, would a few months of preoperative conditioning do more for our patients than asking them to lose weight?
Skinny as a rail
Virginia Rail
The author of this post has no financial relationship with any orthopaedic company.
Follow on twitter: https://twitter.com/shoulderarth
Follow on facebook: https://www.facebook.com/frederick.matsen
Follow on LinkedIn: https://www.linkedin.com/in/rick-matsen-88b1a8133/
References
1. Kunutsor SK. From hip and knee to shoulder: is the obesity paradox becoming a surgical reality? J Bone Joint Surg Am. 2026;108(13):959-963.
2. Valsamis EM, Larsen JB, Sayers A, et al. The association of body mass index with patient outcomes after shoulder replacement surgery: population-based cohort study using linked national data from the United Kingdom and Denmark. PLoS Med. 2025;22(11):e1004786.
3. Singh JA, Sperling JW, Cofield RH. Ninety day mortality and its predictors after primary shoulder arthroplasty: an analysis of 4,019 patients from 1976-2008. BMC Musculoskelet Disord. 2011;12:231.
4. Anakwenze O, Fokin A, Chocas M, et al. Complications in total shoulder and reverse total shoulder arthroplasty by body mass index. J Shoulder Elbow Surg. 2017;26(7):1230-1237.
5. Glenn ER, Zhu AR, Padley JH, McFarland EG. Factors associated with in-hospital death within 30 days after shoulder arthroplasty: a retrospective analysis. J Orthop. 2025;70:326-329.
6. Ottesen TD, Hsiang WR, Malpani R, et al. Underweight patients are the greatest risk body mass index group for 30-day perioperative adverse events after total shoulder arthroplasty. J Am Acad Orthop Surg. 2021;29(3):e132-e142.
7. Hones KM, Hao KA, Cueto RJ, et al. The obesity paradox: a nonlinear relationship between 30-day postoperative complications and body mass index after total shoulder arthroplasty. J Am Acad Orthop Surg. 2023;31(22):1165-1172.
8. Cogan CJ, Flores SE, Freshman RD, Chi HM, Feeley BT. Effect of obesity on short- and long-term complications of shoulder arthroplasty. J Shoulder Elbow Surg. 2023;32:253-259.
9. Parel PM, Bergstein VE, Agarwal AR, et al. Data-driven body mass index threshold associated with increased risk of 2-year periprosthetic joint infection following total shoulder arthroplasty. J Shoulder Elbow Surg. 2024;33:1261-1266.
10. Wagner ER, Houdek MT, Schleck C, et al. Increasing body mass index is associated with worse outcomes after shoulder arthroplasty. J Bone Joint Surg Am. 2017;99:929-937.
11. Theodoulou A, Krishnan J, Aromataris E. Risk of poor outcomes in patients who are obese following total shoulder arthroplasty and reverse total shoulder arthroplasty: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2019;28:e359-e376.
12. Katayama ES, Durisek GR, Bustamante GC, et al. The role of body mass index in survivorship and clinical outcomes in total shoulder arthroplasty. J Shoulder Elbow Surg. 2024;33(9):1980-1989.
13. Onggo JR, Jamieson R, Du P, Gill DRJ, Wang K. Revision rates between obese and nonobese total shoulder arthroplasty patients: an Australian registry data study. J Shoulder Elbow Surg. 2026;35:463-471.
14. Reid JJ, Kunkle BF, Kothandaraman V, et al. Effects of obesity on clinical and functional outcomes following anatomic and reverse total shoulder arthroplasty. J Shoulder Elbow Surg. 2022;31:17-25.
15. Capotosto S, Kim M, Ling K, et al. High and low body mass index increases the risk of short-term postoperative complications following total shoulder arthroplasty. JSES Int. 2024;9(1):141-146.
16. Fu MC, Ondeck NT, Nwachukwu BU, Garcia GH, Gulotta LV, Verma NN, Grauer JN. What associations exist between comorbidity indices and postoperative adverse events after total shoulder arthroplasty? Clin Orthop Relat Res. 2019;477(4):881-890.
17. Traven SA, McGurk KM, Reeves RA, Walton ZJ, Woolf SK, Slone HS. Modified frailty index predicts medical complications, length of stay, readmission, and mortality following total shoulder arthroplasty. J Shoulder Elbow Surg. 2019;28(10):1854-1860.
18. Sridharan MJ, Everhart JS, Frantz TL, Samade R, Neviaser AS, Bishop JY, Cvetanovich GL. High prevalence of outpatient falls following elective shoulder arthroplasty. J Shoulder Elbow Surg. 2020;29(4):699-706.
19. Menendez ME, Ring D, Jawa A. Inpatient falls after shoulder arthroplasty. J Shoulder Elbow Surg. 2017;26(1):14-19.
20. Kaiser TJ, Shanley E, Denninger TR, Reuschel B, Kissenberth MJ, Tolan SJ, Thigpen CA, Pill SG. Preoperative screening in patients having elective shoulder surgery reveals a high rate of fall risk. J Shoulder Elbow Surg. 2021;30(7S):S84-S88.
21. Centers for Disease Control and Prevention. STEADI assessment: Timed Up & Go (TUG). 2017. https://www.cdc.gov/steadi/pdf/steadi-assessment-tug-508.pdf
22. Bohannon RW. Reference values for the Timed Up and Go test: a descriptive meta-analysis. J Geriatr Phys Ther. 2006;29(2):64-68.
23. Shumway-Cook A, Brauer S, Woollacott M. Predicting the probability for falls in community-dwelling older adults using the Timed Up & Go Test. Phys Ther. 2000;80(9):896-903.
24. Barry E, Galvin R, Keogh C, Horgan F, Fahey T. Is the Timed Up and Go test a useful predictor of risk of falls in community dwelling older adults: a systematic review and meta-analysis. BMC Geriatr. 2014;14:14.
