Return to Outdoor Sports After Shoulder Arthroscopy and Arthroplasty, a Pacwest Shoulder Society Survey

Research Objectives: To characterize surgeon’s post-operative return to sport protocols for arthroscopic rotator cuff repair and shoulder arthroplasty (anatomic [TSA] and reverse [RTSA]) with common outdoor sports such as shooting, fishing, and archery.

Design: This is a cross-sectional study surveying expert opinion on return to outdoor sport protocol. A Google Forms survey consisting of 7 global questions (with 5 sub questions each) specific to the return to outdoor sports after shoulder surgery was distributed to fellowship-trained shoulder surgeons. Responses to categorical variables were displayed as percentages and fractions.

Setting: Not applicable

Participants: We invited 182 fellowship trained shoulder surgeons to complete the survey. All invited surgeons are members of the PacWest Shoulder Study group.

Interventions: Not applicable

Main Outcome Measures: The primary outcome of this study is to quantitatively describe surgeons’ preferred timelines regarding return to shooting (handgun, shotgun, and rifle), fishing, and archery after shoulder arthroscopy and arthroplasty.

Results: In total, 81 (44.5%) of the 182 surgeons responded to our survey. No surgeons would apply a lifelong restriction on fishing following shoulder surgery. However, surgeons were most likely to apply casting technique restrictions to patients with large rotator cuff tears with 20 (24.7%) applying some type of casting limitation, most commonly overhead casting. All 81 (100%) surgeons would eventually allow their patients to return to shooting handguns, but increased restrictions were noted for shotgun and rifle shooting, with 2 - 5 (2.5% - 6.2%) surgeons prohibiting returning after arthroplasty. The longest return to sport timeline trend was seen for archery, with 27 (33.3%) surgeons delaying return until after 6 months for those with large rotator cuff tears. The large tear and RTSA groups saw the highest bow weight restrictions, with 22 (27.2%) surgeons limiting their patients in both groups to less than 40 pounds.

Conclusions: In our survey of shoulder surgeons in the western United States, large rotator cuff tears represented the group with the most restrictions applied across all sports. Furthermore, among the three outdoor sports evaluated, the longest trend for return to sport was archery, particularly in the anatomic TSA and RTSA groups. Overall, our findings demonstrate that for the vast majority of patients undergoing shoulder surgery, returning to fishing, shooting, and archery is a viable goal in which they can work with their surgeon and rehabilitation team to pursue.

Author(s) Disclosures: Patrick Denard and Dan Guttmann are consultants for Arthrex, Inc..