JSES - 2026-04-10 - Journal Article
Return to Golf After Shoulder Arthroplasty: An ASES Multicenter Study Predicting Performance after rTSA and aTSA.
Arnold RP, Corban J, Diestel DR, Kirsch JM, Bowler A, Glass EA, McDonald-Stahl M, Stevens CS, Eccles M, Puzzitiello R, Moverman MA, LaMartina J, Middleton A, Le K, Dunn W, ASES Multicenter Research Group
Topics
Key Takeaway
88.9% of golfers returned to play after shoulder arthroplasty at mean 24.3 months, with no significant difference in return rate or performance between rTSA (95.6%) and aTSA (90.0%), though revision arthroplasty independently predicted worse perceived golf performance.
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Summary
This multicenter ASES study evaluated return-to-golf rates and performance outcomes after rTSA and aTSA using sport-specific questionnaires and propensity score matching for age and sex. Of 208 golfers, 88.9% returned to golf postoperatively, with 79.3% reporting maintained or improved performance; propensity-matched comparison of 91 rTSA vs. 48 aTSA patients showed no significant differences in return rate, handicap, or driving distance. Revision arthroplasty was the sole independent predictor of worse subjective golf performance.
Key Limitation
The study relies entirely on self-reported, unverified golf metrics (handicap, driving distance) without objective performance validation, and lacks a non-operative or non-golfer control group to contextualize the magnitude of improvement.
Original Abstract
INTRODUCTION
Return to sport (RTS), particularly golf, and athletic performance following reverse (rTSA) and anatomic (aTSA) shoulder arthroplasty remain largely understudied. Moreover, limited data exist on characteristics that predict successful RTS. This study aimed to evaluate return to golf after shoulder arthroplasty, as well as identify patient factors associated with optimal return to play.
MATERIALS AND METHODS
A multicenter analysis utilizing RTS questionnaires was distributed to patients undergoing rTSA or aTSA at 17 institutions. We assessed preoperative golf participation, return to golf postoperatively, golf performance relative to preoperative level, and frequency of golf participation. Overall subjective satisfaction with their operative shoulder during golf activities was assessed numerically (0-10). Two separate age and sex matched propensity score analyses were performed; first to compare rTSA and aTSA performed for osteoarthritis with an intact rotator cuff (GHOA), and second to compare rTSA performed for GHOA and rotator cuff arthropathy (RCA). Golf-specific outcomes included change of self-reported handicap and driving distance before and after surgery, as well as whether hand dominance influenced outcomes.
RESULTS
208 patients reported golf participation, with a mean follow-up of 24.3 ± 5.7 months. The cohort was 77.9% male, with a mean age of 69.0 ± 7.9 years and BMI of 29.0 ± 5.5. Postoperatively, 88.9% (n=185) returned to golf, and 79.3% (n=165) reported that their performance improved/remained unchanged. Most patients (46.8%) returned within 3-6 months, and another 31.7% between 7-12 months. After propensity score matching, 91 rTSA and 48 aTSA patients were analyzed. Return-to-golf rates were similar (rTSA 95.6% vs. aTSA 90.0%, P=0.313), as were rates of maintained/improved performance (84.6% vs. 81.3%, P=0.313). No significant differences were found in pre- or postoperative handicap, driving distance, or outcomes based on surgery on the dominant vs. nondominant side.
DISCUSSION
Patients demonstrate a high rate of returning to golf following both rTSA and aTSA. Among golfers the ability to return to play and performance level was comparable between arthroplasty types. No significant differences were observed between rTSA and aTSA in terms of postoperative handicap, driving distance, or side of surgery relative to hand dominance. However, despite these similarities, revision arthroplasty was independently associated with worse postoperative patient perceived golf performance. As the number of active patients undergoing shoulder arthroplasty continues to rise, the ability to provide sport-specific counseling is essential for setting realistic expectations and supporting recovery.