Return to sport after shoulder arthroplasty: a systematic review and meta-analysis
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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.
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).
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).
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
KeywordsReturn to sport Shoulder arthroplasty Total shoulder replacement Shoulder hemiarthroplasty Reverse total shoulder replacement Systematic review Meta-analysis
Compliance with ethical standards
Conflict of interest
Dr. Dines and Dr. Warren receive royalties from Biomet, which is related to the subject of this work. Dr. Gulotta receives consultant payments from Biomet, which is related to the subject of this work. None of the other authors has any financial conflict of interest pertaining to this manuscript.
There was no outside funding or grants received that assisted in this study.
Ethical approval was obtained from institutional review board.
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