Firearms Can Be Safely Used Following Shoulder Arthroplasty: Running title: Firearm use after total shoulder arthroplasty

ABSTRACT Introduction Many patients with shoulder arthroplasty enjoy hobbies that require the use of firearms; however, there is a paucity of literature regarding firearm use after arthroplasty. The purpose of this study was to determine if patients can safely engage in shooting sports and/or hunting after shoulder replacement. Methods Retrospective review identified 473 patients with anatomic or reverse shoulder arthroplasty with a minimum of 2-year follow-up. Patients were contacted to complete a survey to assess their participation in hunting and/or shooting sports: type of firearm (shoulder-mounted or handgun), frequency of firearm use, purposes for which firearms were used (recreation, competition, hunting), pain level, limitations during firearm use, and shooting-related complications with the shoulder replacement. Medical records were reviewed to correlate any reported complications due to firearm use. Results Of the 473 patients identified, 245 (52%) completed the firearm survey; 61 (25%) resumed firearm use after surgery, 42 using shoulder-mounted firearms (27 on the operative extremity) and 53 using handguns. Recreational shooting (69%) and hunting (54%) were the primary reasons for firearm use. Eleven patients reported shooting over 500 rounds per year after surgery, with no increased limitations or pain with greater frequency of firearm use. Fifty-two patients reported no or mild pain when shooting, and 49 patients reported no limitations in their ability to shoot. There were no complications related to firearm use reported by patients or in the medical record. Conclusion Patients can safely engage in the use of a variety of firearms after shoulder arthroplasty without pain or limitations or shooting-related arthroplasty complications.