Dominant-Sided Surgery Is Associated With Lower Rates of Return to Sport After Anatomic Total Shoulder Arthroplasty in Active Patients Aged 65 Years and Younger

BACKGROUND: Anatomic total shoulder arthroplasty (aTSA) has demonstrated excellent outcomes for pain relief, functional restoration, and implant survival in patients with glenohumeral osteoarthritis. While return to sport (RTS) has become an increasingly important measure of surgical success in this population, the role of hand dominance in this context remains poorly understood. PURPOSE: To evaluate the impact of hand dominance on RTS after aTSA in patients aged ≤65 years. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: Patients aged ≤65 years who underwent primary aTSA for glenohumeral osteoarthritis between 2016 and 2021 were identified using a prospectively maintained institutional registry. All patients were contacted to assess hand dominance, pre- and postoperative sport participation, timing and level of RTS, and satisfaction. Patients were categorized by whether surgery was performed on the dominant or nondominant shoulder. Patients with ambidextrous hand dominance or bilateral surgery were excluded. Univariate and multivariable comparisons were performed. RESULTS: = .11). CONCLUSION: In patients aged ≤65 years, aTSA on the nondominant shoulder was associated with a significantly higher rate of RTS. These findings suggest that hand dominance may be an important and underrecognized factor in RTS outcomes after aTSA in young, active patients.