Aviation-Focused Shoulder Surgery and Rehabilitation Accelerates Return to Work in Civilian Aircrew.

Abstract

Introduction: Over 30% of temporary aircrew incapacitations are musculoskeletal, with 20% involving the shoulder. The purpose of this study was to analyze return to work (RTW) after shoulder surgery in an aviation-focused surgical practice serving a civilian commercial major airline's crew.

Methods: This retrospective case series reviewed shoulder surgical procedures performed at a specialized orthopedic practice between 2023-2024, excluding second opinions, conservative treatments, and follow-up cases from other surgeries. Unrestricted and full RTW was defined as the days from surgery to the first day of work resumption.

Results: There were 30 patients who underwent shoulder surgery: 19 male pilots (mean age 50.3) and 11 cabin crew (7 females, mean age 36.3; 4 males, mean age 30), with an overall mean cabin crew age of 35.1. The average RTW was 59.2 d. Shoulder dislocations had a mean RTW of 75.7 d, while impingement with acromio-clavicular joint osteoarthritis averaged 55.1 d. Other conditions, including impingement, rotator cuff tears, clavicle fractures, and superior labrum anterior to posterior lesions, ranged from 15-70 d. One complex proximal humerus fracture required 103 d, while two frozen shoulder cases returned after 15 d.

Discussion: This study indicates that most surgically treated shoulder conditions have a mean RTW time of 50-60 d. Shoulder stabilization after dislocation takes 14 d longer, while complex proximal humerus fractures take twice as long. Aviation-focused surgical practices coupled with an aviation-specific musculoskeletal rehabilitation unit facilitate a faster RTW when compared to local regulatory data. Hohmann E, Pieterse R. Aviation-focused shoulder surgery and rehabilitation accelerates return to work in civilian aircrew. Aerosp Med Hum Perform. 2026; 97(7):510-515.