Summary

The majority of patients (23/42 shoulders) report returning to heavy weightlifting postoperatively against senior surgeon’s recommendations.

Abstract

Purpose

Return to sport in high-demand weightlifters following total shoulder arthroplasty has
rarely been investigated, as most surgeons recommend against returning to heavy
lifting postoperatively. The purpose of this study is to determine the incidence of return
to sport, patient reported outcomes, patient satisfaction, performance, and failures in a
specific population of high demand weightlifters that continue lifting after undergoing
total shoulder arthroplasty.

Methods:Retrospective review of a specific population of high demand weightlifters that
underwent anatomic total shoulder arthroplasty with minimum one-year clinical follow
up was conducted. Prospective surveys determining pre- and postoperative
participation in weightlifting included maximum weight, frequency, and duration of
workouts, Single Assessment Numeric Evaluation (SANE), patient satisfaction, and
post-operative range of motion were collected. Secondary outcomes included failure,
revision surgery, risk factors for not returning to weightlifting, and performance
measured as percentage of prior maximum bench press. Bivariate and multivariate
analysis was performed to compare cohorts and identify risk factors, respectively.

Results:Forty-two shoulders in 36 patients who met inclusion criteria (avg age 57.9 years, 97%
male). No patient underwent revision surgery at average 3.6 year follow up (1 to 7
years, SD 1.9 years). The majority of patients (23/42 shoulders) report returning to
heavy weightlifting postoperatively against senior surgeon’s recommendations. Mean
SANE score for current weightlifters and retired weightlifters were 86.9 and 91.6,
respectively ( P = 0.148). In the weightlifting cohort, only 78.3% of patients
achieved patient-acceptable symptom state (PASS) threshold for SANE compared to
89.5% of patients ( p = .332) in the retired cohort. Patient satisfaction and return to
sport satisfaction in current weightlifting shoulders were good-to-excellent in 91.3% ( P
= 0.922) and 82.6% ( P = 0.972) respectively. Patients who continued lifting reported
substantially decreased maximum weight in all lifts compared to pre-symptomatic
maximum.