Sports Activity After Shoulder Replacement - …

1 Sports MEDICINES ports Activity After Shoulder Replacement :A Discussion with Columbia Orthopedics Sports Medicine SpecialistsInterviewer: Christopher S. Ahmad, MDis Chief of Sport Medicine atColumbia University sDepartment of OrthopedicSurgery. He is also Head TeamPhysician for the New YorkYankees, the RocklandBoulders, the New York CityFootball Club of Major LeagueSoccer, and several high schoolsthroughout Manhattan and NewJersey. Additionally, Dr. Ahmadis a member of Major LeagueBaseball s Team PhysicianAssociation and an Advisor onthe MLB s Pitch Smart Program.

2 Interviewee: Shoulder joint Replacement surgery is one of the mostsuccessful procedures to improve quality of life, relievepain, improve function, preserve an independentlifestyle, and contribute to psychological and social well being. Given the good track record of this proceduremany patients undergoing Shoulder Replacement expectto participate in athletic activities After theirreplacement. Athletic Activity increases the forcesacross the Shoulder Replacement that may increasesocket wear, loosen the bone implant fixation, andreduce the longevity of the Replacement .

3 However,there is little evidence to guide patients on theappropriate Activity level After Shoulder Replacement . Dr. Christopher Ahmad sat down with Dr. Charles Jobin,an orthopedic Shoulder & elbow surgeon at NewYork Presbyterian/Columbia University Medical Center, todiscuss Sports Activity After Shoulder Replacement . For more information, visit us : Do your patients have high expectations regarding theirability to return to Sports ? Jobin: Many of my adult athletes with Shoulder arthritis cannotperform at their desired level prior to surgery. They have managedtheir symptoms by altering their swing, throw, or workout routine.

4 Charles M. Jobin, MDis a specialist in the operativeand non operative treatment ofshoulder and elbow disorders inadults. He is an expert inshoulder and elbowreconstruction, as well asminimally invasive,arthroscopic techniques. Hisparticular clinical strengthsinclude treatment of shoulderand elbow arthritis, jointreplacement, rotator cuffdisorders, Shoulder instability,tendon and ligament injuries,and fractures. Dr. Jobin isinvolved in the training ofmedical students, residents,and fellows. He is committed toproviding the highest quality ofmedical care and seeks the bestoutcomes for his patients.

5 Dr. Jobin s research interestsinclude optimization ofshoulder replacementoutcomes, rotator cuff repair,and treatment of tendoninjuries. He has given morethan 15 scientific presentationsat local and national venues,has published 10 articles andauthored 5 book chapters. Additionally, he is active in theAmerican Academy ofOrthopedic Surgeons (AAOS),was part of the EmergingLeader Program at theAmerican OrthopaedicAssociation (AOA), andvolunteered his orthopedicservices in Haiti After thedevastating earthquake. , an athlete himself, hascared for local Sports teamsand provided orthopediccoverage for tournaments.

6 Their symptoms by altering their swing, throw, or workout the pain, loss of motion, and poor physical performance beginsaffecting every day tasks they often are ready for orthopedic the steady functional decline that is common with shoulderarthritis, young adult athletes have very high expectations to return totheir peak level of performance After surgery. Ahmad: What are your general recommendations for participation insports After Shoulder joint Replacement ? Jobin: I counsel most all of my patients who undergo Shoulder jointreplacement that returning to Sports is a realistic goal After surgery,but that the real benefits of surgery are the reliable relief of pain andimprovement in daily activities.

7 I take a common sense approach andthink it is reasonable to perform recreational activities like tennis,golf, fishing, swimming, light weight lifting, but I discourage ultra highimpact activities like boxing, shotgun shooting, or heavy power experience is, and most studies demonstrate, that a return tosporting activities is possible in most patients After shoulderreplacement but that general health and Activity level before surgeryare the strongest predictors of a successful return. In other words,patients who exercise routinely before surgery commonly return tohigh level Sports After Shoulder Replacement surgery.

8 Ahmad: Does Sports participation After Shoulder Replacement affectthe longevity of the Replacement ? Jobin: While no studies have demonstrated cause and effect, it isgenerally understood that excessive or ultra high impact activities willjeopardize the longevity of the Shoulder Replacement by loosening andwearing thin the socket component. It is not known how much activityis too much but I typically encourage a return to moderate Sports andlight weights with high repetition, but I discourage high force and high impact activities like water skiing, contact Sports , or powerlifting.

9 Ahmad: Do you use specialized surgical techniques for young activeathletes undergoing Shoulder Replacement ? Jobin:I tailor each Shoulder joint Replacement to the individualpatient. Younger adult athletes who need Shoulder replacementbenefit from implants that resurface only the diseased area of shoulderjoint cartilage, often this includes a partial Replacement of the ball.(Image 1) If the Shoulder joint is completely diseased then implants areused that minimize unnecessary bone removal with short stems (Image2). Ideal Shoulder implants for athletes allow bone ingrowth into themetal for improved durability without the use of cement, andpreservation of the socket bone to withstand the increased forces ofsport activities.

10 These younger adults athletes also benefit from robustrepair techniques of the muscles and tendons that are entered duringthe Replacement surgery. Image 1: Partial Resurfacing of Humeral Head Focal Cartilage Loss Image 2: Total Shoulder Replacement with Bone Preserving Short StemImplant Ahmad: Please provide an example of a patient who returned tohigh level Sports After Shoulder Replacement ? Jobin: I have numerous patients who returned to sporting activities,but one comes to mind who returned to mixed martial arts. He was ayoung man with terrible Shoulder arthritis and 3 months afterreplacement surgery he was back training, lifting light weights, andhad regained his flexibility.