Return to golf after shoulder arthroplasty: golf performance and outcome scores

Abstract

BackgroundGolf is an increasingly popular sport in the United States, especially among the age group of patients undergoing joint replacement. Return to golf after hip and knee arthroplasty has been previously studied. However, the quality and level of play after total shoulder arthroplasty (TSA) are less defined, especially after reverse shoulder arthroplasty (RSA). We hypothesize that shoulder pain and performance will improve during golf similarly after both anatomic and reverse total shoulder arthroplasties. MethodsThis is a retrospective cohort study of 69 patients identified as playing golf recreationally before undergoing either anatomic or RSA. All patients were cleared to return to golf activities 3 months after surgery. A golf-specific questionnaire was emailed to patients focusing on their experience returning to golf after shoulder arthroplasty. Results after TSA were compared with RSA. Patient-reported and functional outcome scores were evaluated. ResultsThe median age at surgery was 70 (62-73) years with 47 (68.1%) total shoulder replacements and 22 (31.9%) reverse shoulder replacements. Thirty-six (52.1%) patients returned to playing golf within 6 months and sixty (87.0%) patients returned to playing golf within 12 months after surgery. Enjoyment of golf either improved or stayed the same in 51 patients (91.0%). There was no significant change in the handicap score after shoulder replacement. Pain experienced during golf improved significantly from a median visual analog score pain of 6 to 1 (P < .001), with slightly greater improvement in pain for patients who underwent TSA (P = .025). Driving distance improved for 52.2% of patients, with patients who underwent TSA reporting significantly greater improvements in distance (P = .014). For all other questions, patients treated with anatomic shoulder arthroplasty and RSA reported similar experiences. American Shoulder and Elbow Surgeons score, Simple Shoulder Test score, Single Assessment Numerical Evaluation score, visual analog score function, active flexion, and external rotation all significantly improved at the most recent follow-up (P < .001). ConclusionReturn to golf after both reverse and anatomic total shoulder arthroplasties is a realistic expectation, with significant improvements in pain and function while playing golf. Enjoyment playing golf, golf performance, and average length of drive improve in approximately half of all patients. Patients treated with anatomic shoulder arthroplasty and RSA can expect similar golf experiences after surgery, with patients who underwent TSA experiencing a better improvement in driving distance.