Return to Swimming After Shoulder Arthroplasty

J Shoulder Elbow Surg. 2024 Dec 17:S1058-2746(24)00931-5. doi: 10.1016/j.jse.2024.10.013. Online ahead of print.

Abstract

Background: Swimming is one of the most common sporting activities in the United States, and often popular among shoulder arthroplasty patients. While return to sport has become a popular topic recently, the literature focused on swimming is limited. The purpose of this study is to report the rate of return to swim after primary shoulder arthroplasty and evaluate changes in performance after surgery.

Methods: A retrospective query of a single institution's shoulder and elbow surgery repository identified patients treated with primary total anatomic (aTSA) or reverse shoulder arthroplasty (rTSA) by a single fellowship trained shoulder and elbow surgeon between 1/2013 and 1/2022. Those patients who were self-identified as swimmers were surveyed to complete a swimming-specific questionnaire at a minimum two years follow-up. The questionnaire was used to evaluate the ability to return and swimming performance after surgery. Additionally, patient-reported outcome measures (PROMs), range of motion, strength, and satisfaction were evaluated.

Results: A total of 102 (49 aTSA, 53 rTSA) patients responded at an average follow-up of 5.3 years. aTSA patients returned to swimming at a greater rate than rTSA patients (82% vs. 64%; p=.048), but no significant difference in the amount of time taken to return was observed of those who did return to swimming. Patients who returned to swim did so with longer swimming duration per session than they did preoperatively and maintained their primary swim stroke. Of those who returned to swim, overall swimming ability increased in 70% of aTSA and 74% of rTSA patients, and overall enjoyment increased in 70% of aTSA and 71% of rTSA patients.

Conclusion: aTSA patients return to swimming at a higher rate than rTSA patients. However, of those patients who were able to return to swim, there were minimal differences in performance between aTSA and rTSA. Both cohorts demonstrated improved swimming ability and increased enjoyment postoperatively.

Keywords: Patient Reported Outcomes; Return to Sport; Reverse Shoulder Arthroplasty; Swimming; Total Shoulder Arthroplasty.