Return to sport criteria following upper extremity surgery in athletes—part 4: shoulder arthroplasty procedures: a scoping review

Purpose: To describe the reported return to sports (RTS) criteria following all types of shoulder arthroplasty procedures in athletes. Methods: This scoping review was performed using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Scoping Review (PRISMA-ScR) as a guide. A comprehensive search was conducted in four electronic databases (Scopus, Pubmed/MEDLINE, Web of Science, and Google Scholar Advanced Search) in the English Language that reported a minimum of 1 RTS criterion in athletes after shoulder arthroplasty. The data were aggregated and summarized as frequencies, means, and standard deviations. Results: Thirteen studies were included, with a total of 942 athletes with a mean age of 68.7 years. The most commonly used RTS criterion was time from surgery (range 3-6 months), reported by 7/13 (54%) of all studies, followed by restrictions on contact sports (36%). Other reported RTS criteria included no lifting/limited lifting (3/ 13, 23%), physician clearance based on assessment (3/13, 23%), return per patient tolerance (2/13, 15%), and upon return to full range of motion (ROM) and strength in the operated shoulder (1/13, 8%). Three studies (3/13, 23%) allowed for an unrestricted RTSpostoperatively. Conclusion: Thirteen studies reported one or more RTS criteria following shoulder arthroplasty, with time after surgery being the most common RTS criterion used. These results emphasise the need for interprofessional discussions and communication amongst surgeons, physical therapists, and athletic trainers to establish evidencebased RTS criteria following arthroplasty and promote a safe and effective return to sport.