Return to weightlifting following anatomic and reverse shoulder arthroplasty

Weightlifting is a common form of recreational activity that can place higher levels of stress on the shoulder joint and is of particular interest to many patients undergoing shoulder arthroplasty. Despite the growing number of individuals receiving anatomic (aTSA) and reverse total shoulder arthroplasty (rTSA), recommendations regarding return to weightlifting remain unclear. The purpose of this study was to report the rate of return to weightlifting following primary shoulder arthroplasty and to evaluate postoperative function and performance outcomes. A retrospective review of a single institution's shoulder and elbow surgery repository identified patients who underwent aTSA, hemiarthroplasty (HA), or rTSA by a single fellowship-trained shoulder and elbow surgeon between February 2009 and August 2023. Patients who self-identified "weights" or "weight training" as a usual sport on the American Shoulder and Elbow Surgeons (ASES) questionnaire at a minimum 2-year follow-up were included. Demographics, surgical indications, range of motion, patient-reported outcome measures (ASES, Simple Shoulder Test, Single Assessment Numeric Evaluation, visual analog scale pain/function), and return to weightlifting status were analyzed and compared between anatomic (aTSA/HA) and reverse (rTSA) cohorts. Of the 200 shoulder arthroplasty patients self-identified as weightlifters, 184 patients (92%) met inclusion criteria with a mean follow-up of 66.6 ± 34.7 months. The mean age was 64.8 ± 8.1 years, and 76.6% were male. Overall, 70.1% of patients reported no difficulty performing their usual weightlifting activities, 21.7% reported some difficulty, 7.6% reported great difficulty, and only 1 patient (0.5%) was unable to participate. There was no statistically significant difference in rates of full return to weightlifting between patients treated with aTSA or HA and those treated with rTSA (74.3% vs. 56.8%, P = .10). Postoperative range of motion only differed for internal rotation (8 vs. 4, P = .001). Both cohorts achieved substantial postoperative improvements in ASES (mean 86.1 ± 16.8), SANE (83.4 ± 21.6), SST (10.3 ± 2.0), and VAS pain (1.3 ± 2.2) scores. Shoulder arthroplasty patients can expect a high likelihood of returning to weightlifting without difficulty, with excellent pain relief and functional improvement.