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At least 433 records · Page 24Linked to original sources
PubMed2003

Shoulder motions during the golf swing in male amateur golfers.

STUDY DESIGN: Prospective descriptive biomechanical analysis of shoulder motion in golf. OBJECTIVE: To characterize normal shoulder motion during the driving swing in male recreational golfers of various age groups. BACKGROUND: Shoulder trauma accounts for approximately 12% of all golf-related injuries. To design sport-specific rehabilitation programs for the injured golfer and exercise programs for the healthy golfer, clinicians and teachers need quantitative information describing range of motion requirements about the shoulder for the amateur player. METHOD AND MEASURE: Sixty-five male golfers were divided into 3 age groups: college, middle, and senior. A high-speed, 6-camera motion analysis system recorded 3-dimensional bilateral shoulder motion (vertical elevation, horizontal adduction, external rotation, and shoulder tum) for 3 swings of the driver. Group means for ranges and functional end points of motion were compared using a single-factor 1-way ANOVA (alpha = 0.05). RESULTS: All maximum values of shoulder motion were lower in the senior group than in the other 2 groups. At peak backswing, senior golfers exhibited 38 degrees less right-side shoulder external rotation than college golfers. However, from address, seniors horizontally abduct the right arm 18 degrees more than college golfers. In the older golfers, total range of motion was reduced for both shoulders in the vertical plane and for the left shoulder in the horizontal plane. CONCLUSIONS: This study describes shoulder motion for asymptomatic golfers of various age groups. These data may serve as a baseline reference for assessing disease- or injury-related changes in the golf swing and for designing sport-specific exercise and rehabilitation programs.

Adolescent↗
PubMed1995

Biomechanics of total shoulder arthroplasty: a preoperative and postoperative analysis.

To successfully perform a total shoulder arthroplasty, it is essential to understand the normal anatomy and biomechanics of the shoulder joint. Currently, nonconstrained prostheses offer the most consistent and durable long-term results, allowing for the restoration of normal anatomy and motion close to that of the normal shoulder joint. To determine the effects of the disease process, surgical technique, and postoperative rehabilitation on glenohumeral biomechanics after nonconstrained total shoulder arthroplasty, a prospective clinical trial was undertaken to evaluate preoperative and postoperative shoulder motion clinically and roentgenographically in nine patients with severe arthritis. Preoperatively, the ratio of glenohumeral to scapulothoracic motion was 1:2; for every degree of glenohumeral movement there were two degrees of scapulothoracic motion. This was associated with significant pain and decreased motion in the shoulder and represented the patient's attempt to immobilize the glenohumeral joint for pain relief and maximize shoulder movement with scapulothoracic motion. After total shoulder arthroplasty, significant improvements were observed in pain relief, motion, and function; however, the ratio of glenohumeral to scapulothoracic motion was not significantly different. The abnormal ratio indicates that less motion occurs between the prosthetic components compared with a normal joint, whereas scapulothoracic motion is unchanged. Abnormal shoulder biomechanics seem to be a function of the underlying disease process and were not restored after total shoulder arthroplasty. Despite the successes to date, improvements on the current state of the art are still needed, and will occur with better understanding of the complex biomechanics of the shoulder joint.

Biomechanical Phenomena↗
PubMed2003

Consultation and the outcome of shoulder-neck pain: a cohort study in the population.

OBJECTIVE: Despite the high prevalence of shoulder-neck pain in the community, and the fact that it is commonly a persistent and disabling condition, only a minority of sufferers seek medical help. We investigated the association between primary care consultation and subsequent outcome in a cohort of shoulder-neck pain sufferers. METHODS: A population with unilateral shoulder-neck pain was identified by a questionnaire mailed to 4002 adults randomly selected from the register of one family practice. Subjects were asked to shade areas of pain on a blank manikin, and give demographic details and scales of pain, anxiety, and depression. For the following 2 years, general practitioner (GP) consultations for shoulder and neck problems were determined using the practice database. The persistence of pain and degree of shoulder-specific disability, as well as general health status using the Medical Outcome Study Short Form-36 (SF-36), were assessed by means of a second postal survey at 2 years' followup. RESULTS: Three hundred four subjects (11.7% of questionnaire responders) had unilateral shoulder-neck pain at baseline, and 224 were included in the study analyses. Of these, 47 (21%) consulted their GP for shoulder-neck problems over the 2 years. Of the 47 consulters, 36 (77%) reported shoulder-neck pain at followup; this was a higher percentage than that for nonconsulters (RRadjusted = 1.3). Among all subjects with persistent shoulder-neck pain, consulters were more likely than nonconsulters to have shoulder related disability at followup (RRadjusted = 1.6). On average, consulters had more pain and lower levels of physical functioning at followup than nonconsulters as measured by the SF-36. CONCLUSION: The minority of shoulder-neck pain sufferers who consult a primary care practitioner do not have better subsequent pain and disability outcomes than those who do not consult. Our findings raise questions about the current influence of medical care on the natural history of this condition.

Adolescent↗
PubMed1986

Shoulder pain in hemiplegia: statistical relationship with five variables.

The incidence of shoulder pain and the statistical relationship between it and five other variables (patient age, time since onset of hemiplegia, range of hemiplegic shoulder external rotation, spasticity and weakness) were investigated retrospectively. Of 50 consecutive hemiplegic patients whose records were reviewed, 36 had shoulder pain. The variables significantly (p less than 0.01) correlated with shoulder pain were: time since onset of hemiplegia (r = 0.45) and ROSER (r = -0.61). The relationship between shoulder pain and range of shoulder motion remained significant when other factors were partialled out. The relationship between shoulder pain and time since onset was not significant when the affect of range of shoulder motion was partialled out. Therefore, range of shoulder external rotation was considered the factor related most significantly to shoulder pain. This finding suggests that shoulder pain demonstrated by hemiplegia patients may be, in part, a manifestation of adhesive capsulitis.

Adult↗
PubMed1986

[The shoulder joint in chronic polyarthritis].

In patients with rheumatoid arthritis, shoulder problems are very common. In the present study, 96 of 105 patients, i.e., 91%, reported shoulder problems. Thirty-one percent of the patients had such severe shoulder disability that they considered it to be their main rheumatic problem. With increasing duration of the rheumatic shoulder disease, there are progressive destructive changes and a decrease in the range of motion and functional capacity even with conservative treatment, indicating that intervention with surgical procedures may be warranted. In the early effusive stages of rheumatic shoulder disease, radiological synovectomy with beta-emitting radionuclides may be indicated. In proliferative synovitis, surgical synovectomy gives good pain relief and increased shoulder mobility and function. In shoulders with more advanced painful shoulder arthropathy, shoulder replacement is gaining in popularity. However, it is mandatory that candidates must be selected very carefully for shoulder replacement and in patients with severe fibrotic capsulitis, muscular atrophy or mutilation with severe loss of bone, the results after shoulder replacement surgery are often less successful.

Arthritis, Rheumatoid↗
PubMed1986

[Concomitant osseous and ligamentous injuries of traumatic shoulder dislocation and its significance for the pathogenesis of habitual dislocation].

161 consecutive patients with traumatic shoulder luxation between 1975 and 1983 are followed, concerning their evolution to recurrent shoulder dislocation. In 26 patients there was a recurrent shoulder dislocation in a mean time of 19 months after the first luxation. In literature the common level of recurrent dislocation is higher than our 16.1%, despite of the shorter immobilising time after the first shoulder luxation in our center. When there is no evolution to recurrent dislocation, a stable shoulder and a normal shoulder function without pain can be expected in 95%. The compression fracture of the humeral head and the avulsion of the glenoid margin were made responsible for the recurrent dislocation, mostly appearing in adult men, younger than 35 (55% of all recurrent dislocations). Because avulsion fractures of the tuberculum majus don't lead to an unstable fracture neither the existence of a compression defect in the humeral head is pathognomonic for an unstable shoulder, nor a lack of such radiological appearance excludes a recurrent dislocation. In first instance rotatory cuff injuries could be responsible for the instability of the shoulder joint. All patients with this invalidating injuries should be stimulated to an operative procedure, because after correction of an unstable shoulder by a derotation osteotomy of Weber or the elevation of the anterior margin of glenoid in the technique of Trillat good results with normal functional capacities of the shoulder can be expected.

Adolescent↗
PubMed1993

Shoulder dystocia: an analysis of risks and obstetric maneuvers.

OBJECTIVE: The purpose of this study was to determine whether there is a risk profile for predicting or preventing shoulder dystocia and whether any of the obstetric maneuvers to disimpact a shoulder reduce the likelihood of permanent injury. STUDY DESIGN: A retrospective analysis of 14,297 parturients with 12,532 vaginal deliveries and 1765 cesarean sections (12.4%) from January 1986 through June 1990 was performed. A total of 204 maternal and infant charts, related to shoulder dystocia or neonatal injury, were reviewed in depth for age, parity, episiotomy, type of delivery, hemorrhage, maternal obesity, diabetes, weight gain, fetal weight, sex, and Apgar scores. In addition, the type of maneuver or combination thereof used to relieve the dystocia, type of injury to the infant, and follow-up of the injury were reviewed. RESULTS: The 185 coded episodes of shoulder dystocia represent 1.4% of all vaginal deliveries (12,532). There were 42 injuries recorded: 14 fractured clavicles and 28 brachial plexus injuries. An additional 19 patients, not coded for shoulder dystocia, sustained 14 fractured clavicles and five brachial plexus injuries. All but one of the brachial plexus injuries resolved by 6 months. The occurrence of shoulder dystocia increased in direct relationship to the birth weight and becomes significant in newborns over 4000 gm (p < 0.01). The occurrence of a previous large infant was also a significant risk factor (p < 0.01). Diabetes and midforceps delivery become significant factors only in the presence of a large fetus. Obesity, multiparity, postdate pregnancy, use of oxytocin, low forceps delivery, episiotomy, and type of anesthesia were unrelated to shoulder dystocia. No delivery method was without injury. CONCLUSIONS: This study clearly indicates that most of the traditional risk factors for shoulder dystocia have no predictive value, shoulder dystocia itself is an unpredictable event, and infants at risk for permanent injury are virtually impossible to predict. In addition, no delivery method in shoulder dystocia was superior to another with respect to injury. Thus no protocol should serve to substitute for clinical judgment.

Delivery, Obstetric↗
PubMed2003

Shoulder complaints after neck dissection; is the spinal accessory nerve involved?

UNLABELLED: The purpose of the current study was to investigate the relation between shoulder morbidity (pain and range of motion), and the function of the spinal accessory nerve after neck dissection. Identifying dysfunction of the nerve gives insight in the mechanisms of post-operative shoulder complaints. In total 112 patients after neck dissection (73 males/39 females), mean (SD) age 61 (13) years, participated in the study. The mean duration of follow up was 3 (2) years. Five patients had radical, 43 modified radical, 48 supraomohyoid, and 16 posterolateral neck dissection. Thirty-nine complained of shoulder pain of whom 20 (51%) had dysfunction of the spinal accessory nerve, and 19 (49%) did not. In total 29 patients (26%) had dysfunction of the spinal accessory nerve of whom 20 (69%) had shoulder pain. Shoulder pain was significantly related to dysfunction of the nerve (P < 0.001). Twenty-three patients had a difference in active range of motion in shoulder abduction of > or =40 degrees, of whom 22 (96%) had dysfunction of the nerve. A difference in active shoulder abduction of > or =40 degrees was significantly related to loss of function of the spinal accessory nerve (P < 0.001). CONCLUSION: Shoulder pain after neck dissection can only be attributed to dysfunction of the spinal accessory nerve in about 50%. If patients experience shoulder pain after neck dissection examination of the trapezius muscle and active bilateral abduction of the shoulder should be made to find out if the spinal accessory nerve is involved.

Accessory Nerve↗
PubMed2001

The measurement level and trait-specific reliability of 4 scales of shoulder functioning: an empiric investigation.

OBJECTIVE: To evaluate 4 scales of shoulder function with respect to (1) their precision at different levels of shoulder function and (2) the measurement level of their raw scores (interval vs ordinal). DESIGN: Partial credit model calibration. SETTING: Office of private practice orthopedic surgeon with practice limited to the shoulder. PARTICIPANTS: One-hundred ninety-two shoulder patients. INTERVENTIONS: Participants completed the American Shoulder and Elbow Surgeons Patient Self-Evaluation Form (function subscale, modified), the disability subscale of the Shoulder Pain and Disability Index, the Simple Shoulder Test, and the function subscale of the University of Pennsylvania Shoulder Scale. MAIN OUTCOME MEASURES: The patients' responses were calibrated by using a partial credit model. We calculated standard errors of measurement and plotted the 95% confidence interval for different levels of shoulder functioning. We compared scales' raw scores with their equal interval measures obtained in the Rasch calibration. RESULTS: The scales did not measure all levels of shoulder functioning with equal precision, suggesting that commonly used reliability estimates misrepresent scale precision in certain subpopulations. CONCLUSIONS: The scales' raw scores were found to be not of equal interval, calling into question the scoring systems recommended by the developers of these scales and the use of the scores in some statistical procedures.

Adult↗
PubMedDate not supplied

Chiropractic management of a professional hockey player with recurrent shoulder instability.

OBJECTIVE: To describe the clinical management of recurrent shoulder instability in a professional hockey player by using chiropractic management and rehabilitation exercises. CLINICAL FEATURES: A 23-year-old professional hockey player with recurrent left shoulder pain and instability. He had two previous unsuccessful shoulder operations to correct the instability. He reported that the shoulder "slips out" in positions of abduction and external rotation or when the left arm is moved suddenly above shoulder height. The patient was still playing hockey professionally at the time of the initial visit and did not want to have to take time off for another surgery, so he chose to attempt a conservative approach. INTERVENTION AND OUTCOME: The patient had undergone strength training for rehabilitation after each of the previous two shoulder operations and had very strong rotator cuff and scapular musculature. Proprioceptive testing revealed a poor response in the left shoulder compared with the right shoulder. Two subjective outcome measures were used to determine the effectiveness of the treatment protocol in reducing the symptoms of recurrent shoulder instability. Much of the treatment focused on proprioceptive training, soft tissue mobilization, and improving joint function. CONCLUSION: This case demonstrates the potential benefit of chiropractic management and proprioceptive exercises to decrease the symptoms of recurrent shoulder instability.

Adult↗
PubMed2006

Involvement of the anterior portion of the subacromial-subdeltoid bursa in the painful shoulder.

OBJECTIVE: The purpose of our study was to verify that increased widening of the anterior portion of the subacromial-subdeltoid bursa is associated with anteromedial shoulder pain. MATERIALS AND METHODS: Bursography, sonography, and CT were performed in six cadaver shoulders and compared with anatomic sections in neutral position and while the humerus was extended and internally rotated. For the clinical study, the width of the anterior portion of the bursa was measured in both positions in both shoulders of 27 patients referred because of shoulder pain and in eight asymptomatic volunteers. Pain was coded as absent, experienced in the anteromedial portion of the shoulder, or experienced elsewhere but not anteromedially, and we compared the pain scores between shoulder positions. RESULTS: In all cadaver shoulders, when compared with CT scans and anatomic sections, sonography showed the morphology of the bursa, its relationships with surrounding structures, and morphologic changes associated with position. In volunteers, the mean width of the bursa was 0.74 +/- 0.05 and 0.93 +/- 0.09 mm (p = 0.013), respectively, in neutral and stress position. In patients, the same values were 0.70 +/- 0.07 and 0.81 +/- 0.14 mm (p = 0.286) in the asymptomatic side and 1.20 +/- 0.11 and 1.75 +/- 0.23 mm (p < 0.001) in the symptomatic side, respectively. The bursa was wider in patients experiencing pain anteromedially than in those who experienced pain elsewhere and volunteers (p = 0.002 and < 0.001, respectively), and the bursa was wider in symptomatic shoulders than in asymptomatic shoulders (p < 0.001). CONCLUSION: Widening of the anterior portion of the subacromial-subdeltoid bursa is associated with anteromedial shoulder pain and the clinical syndrome of coracoid impingement.

Adult↗
PubMed2003

Shoulder impact response and injury due to lateral and oblique loading.

Little is known about the response of the shoulder complex due to lateral and oblique loading. Increasing this knowledge of shoulder response due to these types of loading could aid in improving the biofidelity of the shoulder mechanisms of anthropomorphic test devices (ATDs). The first objective of this study was to define force versus deflection corridors for the shoulder corresponding to both lateral and oblique loading. A second focus of the shoulder research was to study the differences in potential injury between oblique and lateral loading. These objectives were carried out by combining previously published lateral impact data from 24 tests along with 14 additional recently completed lateral and oblique tests. The newly completed tests utilized a pneumatic ram to impact the shoulder of approximately fiftieth percentile sized cadavers at the level of the glenohumeral joint with a constant speed of approximately 4.4 m/sec. Of the 14 tests, four of them were conducted lateral to the shoulder along the subject's y-axis, four of them were conducted 15 anterior to this axis, and six were conducted 30 anterior to the subject's y-axis. As in the previous testing, the first thoracic vertebrae and both shoulders of the subject were instrumented with tri-axial linear accelerometers on the sternum, clavicle, acromion process, and inferior angle of the scapula. The impacting mass was instrumented with an accelerometer and displacement transducer. In addition to this instrumentation, the tests were documented by high-speed digital imagery. Radiographs (x-rays), magnetic resonance images (MRIs), and autopsies were used to document injury to the subjects. The results from the tests revealed differences between the stiffness of the shoulder when loaded laterally to that when it is loaded obliquely. The shoulder was found to deflect twice as much medially when loaded obliquely then when it is loaded laterally. This can be attributed to the ability of the scapula to slide posteriorly around the thoracic cage. The ability of the shoulder to displace medially while simultaneously deflecting posteriorly in oblique impact is important to replicate in the ATDs because it results in the load being transmitted to the upper thoracic cage.

Journal Article↗
PubMed2006

Assessment of shoulder involvement and disability in patients with ankylosing spondylitis.

The purpose of the study was to evaluate the parameters which have an important role in shoulder involvement and disability in ankylosing spondylitis (AS). Ninety patients with AS were divided into two groups according to the presence of shoulder involvement. Bath AS metrology index (BASMI), ankylosing spondylitis quality of life (ASQoL) and shoulder pain and disability index (SPADI) were used. Ranges of movements of limited shoulders were measured. Mean disease duration, age, BASMI, and ASQoL were higher and hip involvement was more frequent in the shoulder-involved group. Disease duration was found to be the most significant factor in shoulder involvement. A significant relationship was found between all SPADI scores and ASQoL. The SPADI disability score was affected by flexion limitation. Patients with hip involvement and longer disease duration should be evaluated for shoulder involvement. Flexion limitation of shoulder affected shoulder disability and shoulder disability impaired quality of life.

Adult↗
PubMed1999

Open MR imaging of the unstable shoulder in the apprehension test position: description and evaluation of an alternative MR examination position.

The aim of this study was to describe and evaluate an alternative MR assessment procedure for analysis of unstable shoulders. Twelve patients with unilateral recurrent anterior shoulder dislocation had both shoulders examined. Magnetic resonance imaging was performed with an open-MR system in the apprehension position with the shoulder in 90 degrees of abduction and maximum tolerable external rotation. Contrast enhancement was achieved with intravenous gadolinium. Correlations were made to the findings at operation. In 10 of 12 unstable shoulders the inferior glenohumeral ligament labral complex (IGHLLC) was detached from the glenoid as seen on MR and later verified during surgery. In one shoulder MR was unable to show a capsulolabral detachment that was verified at surgery, whereas in one shoulder both MR and surgical assessment revealed no soft tissue detachment (accuracy 92 %). A Hill-Sachs lesion was visualized and verified in all unstable shoulders, whereas the stable controls revealed normal IGHLLC and no Hill-Sachs lesion. Open-MRI evaluation of the shoulder in the apprehension test position may become a useful tool for the evaluation of anterior shoulder instability.

Adult↗
PubMed2006

Shoulder arthroplasty in cases with avascular necrosis of the humeral head.

Avascular necrosis (AVN) is a relatively uncommon cause of glenohumeral arthritis. Previous retrospective reviews of shoulder arthroplasty for AVN have shown very good results in small numbers of patients. This study prospectively evaluated a consecutive series of 21 shoulders in 19 patients treated with the same modular prosthesis at a single institution. Of the shoulders, 8 developed AVN after a proximal humeral fracture, 1 was associated with a massive rotator cuff tear, 10 developed after corticosteroid therapy, and 2 were idiopathic. The patients, 14 women and 5 men, with a mean age of 54 years, were followed up for a mean of 4.7 years (range, 2 to 8 years). Hemiarthroplasty was performed in 15 shoulders, whereas 6 required total shoulder arthroplasty. Assessment included visual analog scales, the Simple Shoulder Test, and the American Shoulder and Elbow Surgeons Shoulder Score Index (SSI). Physical examination was performed, and radiographs were obtained. The visual analog scale scores for pain and function improved significantly after surgery (P < .01). The mean SSI score rose from 36 to 81 (where 0 indicates the worst outcome and 100 indicates the best outcome). The mean number of positive responses on the Simple Shoulder Test increased from 3 to 10. Mean active elevation increased from 88 degrees to 123 degrees . External rotation improved from 7 degrees to 34 degrees , and internal rotation improved from L4 to T12. No difference in outcome was noted based on age or sex. Patients with steroid-related or idiopathic AVN had greater pain and functional impairment preoperatively (mean SSI score, 26) than those with prior fracture or rotator cuff tear (mean SSI score, 49) (P < .01). Postoperatively, however, these groups fared equally well (mean SSI score, 78 vs 82). Shoulder arthroplasty for AVN produces good pain relief and function, although a concurrent series with osteoarthritis yielded better results. Forward elevation did not approach normal as had been previously reported.

Adult↗
PubMed1997

Arthroscopic extra-articular Bankart repair for the treatment of recurrent anterior shoulder dislocation.

This study describes a new arthroscopic procedure for the stabilization of recurrent anterior shoulder dislocations. The technique involves two important features. The first is the anterior inferior transmuscular approach through the subscapularis muscle, which permits self-locking implants to be inserted into the anterior inferior third of the glenoid rim so that they oppose the direction of pull of the capsule. This approach was studied on 79 cadaveric shoulders before clinical application. The second feature is the extracapsular (extra-articular) location of the self-locking implants, which permits a superomedial capsular shift as required. The technique offers a high degree of capsular stability. Of a total of 318 patients undergoing this procedure, the first 100 shoulders (98 patients) were evaluated postoperatively at an average of 35 months (range, 18 to 62 months). The diagnosis in all cases was traumatic recurrent anterior shoulder dislocation. Repair of the capsule was performed initially with screws and later with absorbable tacks. The overall recurrence rate was 9% (9 shoulders). Excluding the first 30 shoulders to take account of the learning curve, the recurrence rate for the subsequent 70 shoulders was only 5.7%. Limitation of external rotation at 0 degrees abduction averaged 6.7 degrees and 6.1 degrees at 90 degrees abduction for all shoulders; 61% of participants in overhead sports and 70% of participants in contact sports resumed their preinjury activities. The recurrence rate for patients involved in overhead sports was 10% and for collision sports it was 14%. There were no recurrences in the case of patients whose sports involve minimum risk to the shoulder (cycling, jogging). Most recurrences were observed in patients with lax shoulders and small Bankart lesions.

Adolescent↗
PubMedDate not supplied

Manipulation under anesthesia for primary frozen shoulder: effect on early recovery and return to activity.

Frozen shoulder is still an enigma of shoulder surgery. It is reported that at 2 years from onset, most patients will have recovered whether treated or not. However, the duration of morbidity has major implications for patient function and satisfaction. In view of this fact, we have focused on the early effect of manipulation under anesthesia on shoulder function. We prospectively assessed 39 shoulders in 37 patients who were given the diagnosis of primary frozen shoulder between June 1997 and June 1998 and were treated with manipulation under anesthesia of the affected shoulder. The median preoperative Constant score rose from 24 of 100 to 63 of 100 at 3 to 6 weeks and to 69 of 100 at 3 months. Improvement was maintained at a mean follow-up of 11 months after surgery (range 6 to 18 months). Overall, 94% of patients were satisfied with the procedure. At 3 months 59% (23 shoulders) were rated as having no or mild disability only, 28.2% (11 shoulders) as having a moderate degree of disability, and 12.8% (5 shoulders) as having a severe degree of disability. Of the 5 cases scoring less than 50 of 100 (mean 40) at 3-month follow-up, 1 had unmasked symptoms of a subacromial impingement syndrome that has required further treatment. There was no relationship between the initial Constant score or the initial range of movement after manipulation and the eventual result. We recommend the use of manipulation under anesthetic in primary frozen shoulder to restore early range of movement and to improve early function in this often protracted and frustrating condition.

Adult↗
PubMedDate not supplied

Shoulder arthroplasty in recreational golfers.

A retrospective review of 24 patients who had shoulder arthroplasty revealed that 23 were able to resume playing golf. The 23 patients (mean age 52.4 years, range 26.4 to 71.9 years) underwent 26 shoulder arthroplasties, 20 total shoulder arthroplasties, and 6 hemiarthroplasties. The average follow-up was 53.4 months (range 24.4 to 127.2 months). The average length of time from shoulder arthroplasty to playing an entire round of golf was 4.5 months. Eighteen patients were able to report their preoperative handicap and noted an average improvement after surgery of almost 5 strokes. Playing golf did not result in increased radiographic evidence of component loosening, and no increase occurred in lucent lines when the golfers were compared with a control group of 76 patients with osteoarthritis who had 103 shoulder arthroplasties (P < .05). Fifty members of the American Shoulder and Elbow Society were mailed a standardized questionnaire of 11 questions concerning patients who had shoulder arthroplasty and played golf. Most surgeons (91%) encouraged such patients to resume playing golf. The average length of time members of the Society recommended that patients should wait after shoulder arthroplasty before resuming golf was 4.3 months. Approximately 60% of surgeons believed that no limit should be placed on the number of golf rounds played weekly, and 91% denied an increase in complications among those who returned to playing golf after undergoing shoulder arthroplasty. Fewer than one third of the surgeons (29.5%) believed that component wear would be a problem in patients who undergo shoulder arthroplasty and play golf frequently and would recommend a hemiarthroplasty for an active golfer because of concern about future glenoid problems.

Adult↗