Return to Outdoorsman Sports After Primary Total Shoulder Arthroplasty

With the increasing popularity of shoulder arthroplasty, indications and usage has expanded to younger more physically active patients. Limited knowledge exists on return to outdoorsman sports after shoulder arthroplasty.

To determine return to outdoorsman sports, including fishing, shooting, archery, and rowing, after primary total shoulder arthroplasty at a minimum 2-year follow-up.

Case series; Level of evidence, 4.

A retrospective study was performed on patients who underwent primary reverse or anatomic total shoulder arthroplasty between 2012 and 2022 who participated in outdoorsman sports, including fishing, shooting, archery, and rowing, with a minimum 2-year follow-up. Questionnaires were expanded to explore patients' preoperative and postoperative activity with regard to outdoorsman sports. Patient-reported outcomes (PROs), including visual analog scale for pain (VAS), American Shoulder and Elbow Surgeons (ASES), and Subjective Shoulder Value, as well as active range of motion including forward flexion, external rotation, internal rotation, were collected pre- and postoperatively.

A total of 102 patients met study criteria and responded. Overall, 77% returned to outdoorsman sports, with 80%, 85%, 50%, and 68% returning to fishing, shooting, archery, and rowing, respectively. Of those who returned, 86% reported being mostly or completely satisfied with their performance postoperatively, with 77% reporting a return to at least the same level of activity. Among those who returned, 61% did so within 6 months postoperatively. Patients from all sports showed significant clinical improvement in forward flexion (P≤ .003), external rotation (P≤ .006), and PROs (P≤ .006) at a mean postoperative follow-up of 38 ± 12 months. Between sports, postoperative VAS (P = .04) and ASES (P = .03) values were significantly different, with shooting showing lower ASES (83) and higher VAS (1.5) scores, despite demonstrating the highest return rate (85%). When considering arm dominance, return rates were comparable between patients who had surgery on their dominant arm and those treated on their nondominant arm across each sport.

Participants had a 77% return to outdoorsman sports, such as fishing, shooting, archery, and rowing, with >50% doing so within 6 months of primary total shoulder arthroplasty. Respondents who participated in rowing and archery returned at lower rates compared with fishing and shooting, despite shooting's showing higher pain postoperatively. Activities entailing greater shoulder demands may hinder a patient's ability to return after arthroplasty.