Patient reported activities after shoulder replacement: total and hemiarthroplasty

Hypothesis/Background: The indication to perform a shoulder arthroplasty is guided in part by a patient's intended level of activity after surgery. What level of activity should be safely recommended, and, presently, patient reported activity level is unknown. The purpose of this study was to define and compare the self-reported activities of patients following shoulder arthroplasty either total (TSA) or hemiarthroplasty (HA). Methods: Two groups of 75 patients each following TSA or HA were matched by age, sex, operative side, timing from surgery, and state of residence. A mailed questionnaire asked patients to report on their level of pain, motion, strength, and choice of 72 different activities. Reported activities were classified as low demand, intermediate demand, or high demand. Results: Ninety-nine patients completed the survey, 52 in the TSA group (average age 62 years; 30F:22M), and 47 in the HA group (average age 62 years; 27F:20M). No difference on a pain scale was reported between groups. Better results were reported in the TSA group in forward flexion (P = .006), internal rotation (P = .04), and strength (P = .04). The most commonly reported activities in each category were: low demand (eg, cooking), medium demand (eg, gardening), and high demand (eg, snow shoveling). For each activity there was no significant difference between groups. Discussion/Conclusion: Conventional thinking that HA provides for more activity is not supported by patient-reported activities when compared with TSA. Patients following TSA reported better motion and strength and were equally as active as the HA group. Level of evidence: Level III, Retrospective Case Control Study. (C) 2011 Journal of Shoulder and Elbow Surgery Board of Trustees.