Return to yoga following anatomic or reverse total shoulder arthroplasty

Background

Returning to sport is an important consideration for joint replacement. Currently, there is a lack of knowledge regarding returning to yoga following shoulder arthroplasty. The purpose of this study was to examine patients’ ability to return to yoga after primary total shoulder arthroplasty. Secondary outcome measures were analyzed including range of motion (ROM) and patient-reported outcomes (PROs). Additionally, any differences between anatomic total shoulder arthroplasty (aTSA) and reverse total shoulder arthroplasty (rTSA) were investigated.

Methods

A retrospective study was performed on patients who underwent primary aTSA or rTSA between 2012 and 2022. Inclusion criterion was a minimum follow-up of 2 years, and yoga was reported as their primary sporting activity prior to arthroplasty. Yoga participation was recorded before and after shoulder arthroplasty, as well as time to return to previous activity level and satisfaction. Range of motion including forward flexion, external rotation, and internal rotation, as well as PROs including visual analog scale for pain, American Shoulder and Elbow Surgeons score, and subjective shoulder value were collected preoperatively and postoperatively. Postoperative results were compared based on patients’ ability to return to participation in yoga.

Results

Fifteen patients (6 aTSA and 9 rTSA) with a mean age of 69 ± 6 years met the study criteria and were evaluated at a mean of 44 ± 22 months postoperative. At 6 months postoperative, 60% (9/15) of patients reported being able to return to their activity, whereas 100% (15/15) had returned by the 12-month postoperative point. At the final follow-up, 80% (12/15) of patients noted that their ability to return to yoga following shoulder arthroplasty improved compared to baseline, 13% (12/15) reported that this ability was unchanged, and 7% (1/15) reported decreased ability.

There was no statistically significant difference in PROs between rTSA and aTSA (visual analog scale P = .08, American Shoulder and Elbow Surgeons score P = .79, subjective shoulder value P = .29). Likewise, there was no statistically significant difference in postoperative ROM when comparing rTSA and aTSA groups (forward flexion P = .47, external rotation P = .22, internal rotation P = .29).

Conclusion

Patients who engage in yoga have a high return to sport rate following either aTSA or rTSA, although full return may take up to 1 year postoperatively. The vast majority of patients also report improvement in their ability to perform yoga following shoulder arthroplasty. Among yoga participants, postoperative ROM, including internal rotation, appears to be similar between aTSA and rTSA.