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The findings of 2 studies presented at the 2023 annual meeting of the American Academy of Orthopaedic Surgeons demonstrate that after shoulder arthroplasty, patients can return to golfing or playing racquet sports in 6 months to 1 year, with a significant improvement in pain symptoms and a good chance that their game will get better.

Golf Performance and Outcomes

In the retrospective cohort study, Return to Golf after Shoulder Arthroplasty: Golf Performance and Outcome Scores, 69 patients who played golf recreationally underwent total shoulder arthroplasty (TSA; n=47) or reverse shoulder arthroplasty (RSA; n=22)) between January 1, 2009, and Jan. 1, 2019. All patients in the cohort returned to play following surgery. The cohorts were similar in age, with a median age of 66 for TSA and 71 for RSA.

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The researchers developed a questionnaire to assess the patients’ experience, including:

• Time to return to golf after shoulder arthroplasty
• Amount of golf played in a month
• General activity level
• Golf handicap
• Change in drive length
• Golf accuracy and golf performance
• Visual analog score (VAS) pain experienced while golfing
• Overall enjoyment while golfing

The researchers compared results from patients who had undergone TSA with those of patients who had undergone RSA. Their findings included the following:

• The time to return to play was similar between the 2 groups: 48.9% of TSA patients returned to golf within 6 months and 85.1% within 1 year, while 59.1% of RSA patients returned to playing within 6 months and 90.9% returned within 1 year.
• The groups had similar frequencies of play and similar physical activity levels postoperatively. The RSA patients who reported a decrease in golfing frequency most often indicated that pain was the main factor in golfing less often that before surgery.
• Overall, golf performance improved or stayed the same for 81.8% of patients, with 91% saying their enjoyment for the game either increased or stayed the same.
• No significant change in golf handicap was reported by either group. However, almost half of patients reported an increase in their driving distance following surgery (60% TSA vs. 47.6% RSA).
• Pain significantly improved after surgery (median VAS pain went from 6 to 1), with a slightly greater improvement in pain for TSA patients.

Racket Sports Performance and Outcomes

In the retrospective study, Racket Sports After Shoulder Arthroplasty, 39 patients who played a racket sport recreationally underwent TSA (n=26) or RSA (n=13) between January 1, 2009, and January 1, 2019. The racquet sports included tennis (n=26), pickleball (n=8), and racquetball (n=5). The groups were similar in age, with a median age of 69 for TSA and 71 for RSA.

As with the golf study, patients in the racket sport study completed a questionnaire about their experience returning to racket sports after shoulder arthroplasty, including:

• Time to return to racket sports following surgery
• Amount of racket sport played in a month
• General activity level
• VAS pain while playing
• Performance
• Enjoyment of the sport

After comparing results from TSA patients with those of RSA patients, the researchers found that:

• The overall ability to return to play was 90%, with 80% of RSA patients and 96% of TSA patients returned to play their racket sport, demonstrating no significant difference between TSA and RSA in the time it took to return to play. About half of TSA and RSA patients returned within 6 months. Within 1 year, 81% of TSA patients and 92% of RSA patients had returned to play.
• Four patients (3 RSA, 1 TSA) were unable to continue playing a racket sport after surgery, mainly due to an issue with their shoulders.
• Only 9 patients played their racket sport less following surgery, with 8 saying the reason was unrelated to their shoulder and 1 stating it was due to pain in their shoulder while playing.
• Of all patients, 90% said their performance improved or stayed the same, while 98% said they enjoyed playing their racket sport more or the same as prior to surgery. Few patients expressed enjoying their sport less postoperatively: 4% for TSA and 0% for RSA.
• Both groups had a 5-point improvement in VAS pain score after shoulder arthroplasty.

“These studies are really helping us define patient expectations and … show patients what is realistic in regard to returning to play golf or tennis after shoulder arthroplasty,” said Jonathan C. Levy, MD, an author of both studies. He is the director of the Levy Shoulder Center at Paley Orthopedic & Spine Institute, Boca Raton, Florida.

“There have definitely been times when it made me pause to ask if I was going to take away a sport my patient is passionate about in an effort to give them pain relief. However, now I can say with confidence that you will be able to get back to playing tennis or golf and still enjoy the game.”