73. PATIENT REPORTED ACTIVITIES AFTER SHOULDER REPLACEMENT: HEMIARTHROPLASTY VERSUS TOTAL SHOULDER ARTHROPLASTY

Abstract

Purpose: The indication to perform a total shoulder arthroplasty (TSA) versus a hemiarthroplasty is guided by a patient’s intended level of activity after surgery. It is unclear what activities patients actually perform following shoulder replacement, therefore, the purpose of this study was to compare the self-reported activities of patients following either a TSA or hemiarthroplasty.

Method: Two groups of 75 patients each, following TSA or hemiarthroplasty, were matched for a variety of demographic variables. A mailed activity questionnaire asked patients to report their level of pain, motion, strength, and a choice of 70 different activities. Reported activities were classified as high (i.e. tennis) or low (i.e. fishing) demand, and categorized as household (i.e. cooking), yard work (i.e. gardening), sporting (i.e. golf), or musical (i.e. piano).

Results: Ninety-six (64%) patients completed the survey, 50 in the TSA group (27F:19M, avg. 53.2 yrs), and 46 in the HA group (29F:21M, avg. 53.5 yrs). Pain was not different between groups (3.6/10 TSA: 3.9/10 HA), yet a significant difference was reported in forward flexion (145° TSA: 120° HA, P< .002) and strength (6.3/10 TSA: 5.3/10 HA, P< .01). Across all categories whether it be high or low demand, the TSA group (10.4 activities/person) reported more activities compared with the hemiarthroplasty group (8.6 activities/person).

Conclusion: The conventional understanding that a hemiarthroplasty provides the possibility for more activity following surgery is not supported by our data. Patients following a TSA reported better motion and strength and were more active than the hemiarthroplasty group.