Anatomic total shoulder arthroplasty for patients receiving workers' compensation

Abstract

Background: Studies have demonstrated that receiving workers' compensation (WC) benefits can be a negative predictor of outcomes after orthopedic procedures. This study compares postoperative outcomes of anatomic total shoulder arthroplasty (TSA) between patients receiving WC benefits and a control group that did not.

Methods: A cohort of 13 consecutive TSA patients with WC benefits were compared with a control group of 63 consecutive patients with a minimum of 2 years of follow-up during the same period. Patient demographics, American Shoulder and Elbow Surgeons scores, 12-Item Short Form Health Survey scores, return to work status, and time out of work were evaluated.

Results: The WC TSA cohort consisted of 13 men and no women with a mean age of 55.9 years. Twelve of the 13 were laborers. The TSA control group consisted of 36 men and 27 women with a mean age of 63.2 years (P = .01). The American Shoulder and Elbow Surgeons scores at final follow-up were significantly lower in the WC cohort (73.6) compared with the control group (86.6; P = .01). However, the 12-Item Short Form Health Survey physical and mental component summary scores were not significantly different (P = .09 and P = .6). Only 4 of the 13 WC patients returned to work.

Conclusion: Compared with a non-WC population, patients with WC who received an anatomic TSA are more likely to be male, younger, and a laborer. Outcomes are generally excellent and better than those of other WC shoulder surgery cohorts in the literature; however, the outcomes are relatively worse than in the non-WC TSA patients. A significant number of WC patients are unable to return to work after TSA.

Keywords: Workers' compensation; disability; osteoarthritis; total shoulder arthroplasty.