Aviation-Focused Shoulder Surgery and Rehabilitation Accelerates Return to Work in Civilian Aircrew.

INTRODUCTION

Over 30% of temporary aircrew incapacitations are musculoskeletal, with 20% involving the shoulder. The purpose of this study was to analyze return to work (RTW) after shoulder surgery in an aviation-focused surgical practice serving a civilian commercial major airline's crew.

METHODS

This retrospective case series reviewed shoulder surgical procedures performed at a specialized orthopedic practice between 2023-2024, excluding second opinions, conservative treatments, and follow-up cases from other surgeries. Unrestricted and full RTW was defined as the days from surgery to the first day of work resumption.

RESULTS

There were 30 patients who underwent shoulder surgery: 19 male pilots (mean age 50.3) and 11 cabin crew (7 females, mean age 36.3; 4 males, mean age 30), with an overall mean cabin crew age of 35.1. The average RTW was 59.2 d. Shoulder dislocations had a mean RTW of 75.7 d, while impingement with acromio-clavicular joint osteoarthritis averaged 55.1 d. Other conditions, including impingement, rotator cuff tears, clavicle fractures, and superior labrum anterior to posterior lesions, ranged from 15-70 d. One complex proximal humerus fracture required 103 d, while two frozen shoulder cases returned after 15 d.

DISCUSSION: This study indicates that most surgically treated shoulder conditions have a mean RTW time of 50-60 d. Shoulder stabilization after dislocation takes 14 d longer, while complex proximal humerus fractures take twice as long. Aviation-focused surgical practices coupled with an aviation-specific musculoskeletal rehabilitation unit facilitate a faster RTW when compared to local regulatory data. Hohmann E, Pieterse R. Aviation-focused shoulder surgery and rehabilitation accelerates return to work in civilian aircrew. Aerosp Med Hum Perform. 2026; 97(7):510-515.