Systematic Reviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Sep 18, 2022; 13(9): 837-852
Published online Sep 18, 2022. doi: 10.5312/wjo.v13.i9.837
Return to work following shoulder arthroplasty: A systematic review
Simon P Lalehzarian, Avinesh Agarwalla, Joseph N Liu
Simon P Lalehzarian, The Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL 60064, United States
Avinesh Agarwalla, Department of Orthopedic Surgery, Westchester Medical Center, Valhalla, NY 10595, United States
Joseph N Liu, USC Epstein Family Center for Sports Medicine, Keck Medicine for USC, Los Angeles, CA 90033, United States
Author contributions: All authors made significant contributions toward the preparation of this manuscript. Lalehzarian SP wrote the article, critically revised the article, and participated in the final approval of the version to be published; Agarwalla A critically revised the article and participated in the final approval of the version to be published; Liu JN designed the work, critically revised the article, and was responsible for final approval of the version to be published.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joseph N Liu, MD, Assistant Professor, USC Epstein Family Center for Sports Medicine, Keck Medicine for USC, 1520 San Pablo St #2000, Los Angeles, CA 90033, United States. joseph.liu@med.usc.edu
Received: February 1, 2022
Peer-review started: February 1, 2022
First decision: May 31, 2022
Revised: June 13, 2022
Accepted: August 22, 2022
Article in press: August 22, 2022
Published online: September 18, 2022
Processing time: 227 Days and 11.5 Hours
ARTICLE HIGHLIGHTS
Research background

Over the last two decades, the number of shoulder arthroplasties, including total shoulder arthroplasty (TSA), reverse TSA (rTSA), and shoulder hemiarthroplasty (HA), has increased at exponential rates. Due to satisfactory clinical and functional long-term outcomes, the number of shoulder replacements performed will continue to rise into this next decade. Additionally, these procedures are becoming more prevalent in younger and more active populations. With younger individuals who compose a significant amount of the workforce receiving shoulder replacements, patients will begin to place a higher priority on their ability to return to work following shoulder arthroplasty.

Research motivation

Prior studies have shown varying levels of return to work after shoulder arthroplasty based on arthroplasty type, diagnosis, and work intensity. While informative, a compilation comparing various demographics, arthroplasty types, diagnoses, and work intensities has not been performed in recent years.

Research objectives

The aim of the review article was to summarize return to work outcomes following TSA, rTSA, and HA, and analyze the effects of workers’ compensation status on return to work rates and ability.

Research methods

This systematic review and analysis was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search regarding return to work following shoulder arthroplasty was performed using four databases through January 2021. All studies included in this review were analyzed by at least two authors. Included studies were then evaluated using the Methodological Index for Non-Randomized Studies checklist.

Research results

The majority of patients undergoing TSA, rTSA, or HA were able to return to work between one to four months, depending on work demand stratification. While sedentary or light demand jobs generally have higher rates of return to work, moderate or heavy demand jobs tend to have poorer rates of return. Furthermore, workers’ compensation status negatively influenced clinical outcomes following shoulder arthroplasty. Through a pooled means analysis, we proposed guidelines for the average time to return to work following TSA, rTSA, and HA.

Research conclusions

The majority of patients were able to return to work following TSA, rTSA, or HA. Understanding outcomes for rates of return to work following shoulder arthroplasty should assist surgeons and patients in managing expectations in clinical practice.

Research perspectives

Further research and analyses comparing short- and long-term outcomes following TSA, rTSA, and HA and a patients’ ability to return to work would provide tremendous benefit. Additionally, revision arthroplasty and ability to return to work may be a topic worth exploring as the average age of patients undergoing shoulder replacement is decreasing.