Return to Work After Shoulder Replacement for Glenohumeral Osteoarthritis Is Similar When Hemiarthroplasty Is Compared t
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ORIGINAL ARTICLE
Return to Work After Shoulder Replacement for Glenohumeral Osteoarthritis Is Similar When Hemiarthroplasty Is Compared to Total Shoulder Arthroplasty Joseph N. Liu, MD & Grant H. Garcia, MD & Anirudh K. Gowd, MD & Gregory Mahony, MS & Alec Sinatro, BA & Hao Hua Wu, MD & David M. Dines, MD & Russell F. Warren, MD & Lawrence V. Gulotta, MD
Received: 12 January 2019/Accepted: 26 April 2019 * Hospital for Special Surgery 2019
Abstract Background: Return to work after shoulder arthroplasty for glenohumeral osteoarthritis (OA) is an important consideration for an aging workforce. Questions/ Purposes: The aim of this study was to compare the shoulder function, pain levels, and rate of return to work in patients treated with anatomic total shoulder arthroplasty (aTSA) versus humeral hemiarthroplasty (HHA). Methods: A retrospective review of consecutive HHA patients was performed of our institution’s shoulder arthroplasty registry.
Level of Evidence: III, retrospective cohort design, treatment study Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11420-019-09692-0) contains supplementary material, which is available to authorized users. J. N. Liu, MD (*) Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA, USA e-mail: [email protected] G. H. Garcia, MD Seattle Orthopedic Center, Seattle, WA, USA A. K. Gowd, MD Wake Forest University Baptist Medical Center, Winston-Salem, NC, USA G. Mahony, MS : A. Sinatro, BA : D. M. Dines, MD : R. F. Warren, MD : L. V. Gulotta, MD Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, NY, USA H. H. Wu, MD Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, CA, USA
Inclusion criteria were pre-operative diagnosis of end-stage OA and more than 2 years’ follow-up. HHA patients were statistically matched to aTSA patients and then screened for preoperative work status; 26 HHA and 23 aTSA patients worked before surgery. There was no difference in average age (HHA, 62.4 years; aTSA, 61.7 years) or follow-up (HHA, 67.5 months; aTSA, 66.9 months). Results: Average American Shoulder and Elbow Surgeons (ASES) scores (HHA, 37.6 to 70.3; aTSA, 35.6 to 80.1) and visual analogue scale (VAS) for pain scores (HHA, 6.1 to 2.3; aTSA, 6.5 to 0.6) improved in both groups. However, HHA patients had worse final VAS scores, and aTSA patients were more satisfied (100% vs 77%); 61.5% of HHA patients returned to work post-operatively versus 87.0% of aTSA patients. There was no difference in time to return to work (HHA, 1.9 ± 2.3 months; aTSA, 1.3 ± 1.0 months). Conclusion: Patients with shoulder OA undergoing aTSA have higher rates of return to work, function, and satisfaction than those undergoing HHA. Keyword anatomic total shoulder arthroplasty . hemiarthroplasty . work . shoulder replacement . job . occupation . osteoarthritis Introduction Shoulder arthroplasty utilization continues to grow at an unprecedented rate, with an almost fivefold increase in th
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