Effect of Hand Dominance on Range of Motion and Outcomes Following Reverse Total Shoulder Arthroplasty

Abstract

Introduction Upper extremity hand dominance greatly impacts the functional ability to perform activities of daily living. No studies have evaluated the effects of hand dominance on patient outcomes and postoperative range of motion (ROM) after reverse total shoulder arthroplasty (rTSA). Methods From 2009 to 2014, functional data and patient-reported outcomes were prospectively collected from patients who underwent rTSA at a single institution. Baseline characteristics were assessed and patients were stratified based on whether surgery was performed on the dominant extremity. A repeated-measures ANOVA was performed to determine differences in outcomes between cohorts. Results Eighty-seven rTSAs were performed on the patients’ dominant (DO) shoulder and 53 on the nondominant (ND) shoulder. Both groups had similar age, hospital length of stay, body mass index, and Charlson Comorbidity Index. Prior to surgery, the ND group had significantly lower active forward elevation (FE) (68°) compared to the DO group (87°, P = .04). Both groups had significant increases in FE ROM at both 1 and 2 years compared to preoperatively ( P < .001). At 2 years, both groups had equivalent FE but the ND group gained significantly more than the DO group (67° vs 43°) ( P = .005), mainly due to the preoperative FE. This finding was similar for shoulder abduction. Both groups had significant improvements in American Shoulder and Elbow Surgeons scores ( P < .001) and Visual Analog Scale pain scores ( P < .001) at 1 and 2 years postoperatively, with no significant differences between the groups. Conclusion rTSA is a reliable operation which consistently improves patient ROM, function, and pain scores at 2 years. However, baseline FE is higher in patients undergoing surgery for the DO extremity, which indicates an inability to tolerate as much functional deficiency compared to the ND extremity.