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Sports often possible after shoulder replacement
Last Updated: 2010-07-28 13:40:04 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Many older adults who were active in recreational sports like swimming and golfing can get back into the game after having a total shoulder replacement, a new study suggests.
Total shoulder replacements are typically performed for severe cases of arthritis, after conservative therapies -- like anti-inflammatory painkillers and physical therapy -- fail to bring enough pain relief. The surgery involves replacing the damaged part of the bone and cartilage with a metal and plastic implant.
Shoulder replacements are much less common than total hip and knee replacements; in the U.S., about 23,000 people have the shoulder procedure each year, compared with more than 700,000 having a knee or hip replacement.
So there have also been far fewer studies looking at patients' athletic abilities after shoulder replacement, which costs about $10,000, according to a 2007 study, compared with the more common procedures.
The new study, published in the American Journal of Sports Medicine, followed 100 older adults who had a total shoulder replacement at one Swiss medical center. It found that of the 55 patients who were regularly active before their shoulder disease, 89 percent were active an average of three years following surgery.
The most common post-surgery activities were swimming, golf, cycling and "fitness training."
A minority of patients who were active before their shoulder problems became too severe did not return to recreational sports. But no patient said they had to stop their activities because of the surgery itself, according to Dr. Katrin Schumann and colleagues at the Schulthess Clinic in Zurich.
The surgery did not eliminate shoulder problems in those patients who returned to sports. Of the 49 patients who were active before their shoulder problems and after surgery, 37 percent said that, even after the procedure, they still had limitations on the physical activities they could do.
Still, 69 percent said they were able to return to the same sports they enjoyed before their shoulder disease, at the same level of intensity, after they had surgery.
Most of those patients started sports again within six months, but it typically took about a year for them to return to "maximum performance," according to Schumann's team.
The findings, the researchers write, suggest that patients who were active before total shoulder replacement have a "high" probability of being able to return to sports after surgery.
The study has its limitations, however. It was a case-series, which means it followed the outcomes of a group of patients, but had no "control" group -- people with shoulder arthritis who did not a joint replacement -- to serve as a comparison.
The patients were also treated at a single medical center, and as with other types of surgery, the long-term results depend at least partly on the surgeon's experience and expertise.
Schumann's team also points out that the average follow-up of three years is fairly short. Longer term studies, they write, are needed to see whether returning to sports causes patients' joint replacements to wear more rapidly or have a higher rate of loosening -- which may require further surgery.
American Journal of Sports Medicine, online July 8, 2010.
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