Modern airport security checkpoints: how do updated screening practices with full-body scanners and TSA PreCheck affect patients with shoulder replacements?

Over the past decade, full-body millimeter wave scanners have replaced metal detectors as the primary screening technology in US airports. Few studies have evaluated the activation rates of these machines in travelers with joint replacements, and even less attention has been placed on those with shoulder replacements who might have difficulty performing the arm raise maneuver. Therefore, we sought to quantitatively and qualitatively evaluate the experience of shoulder arthroplasty patients navigating modern airport security checkpoints. Patients who received a shoulder replacement at our institution were contacted. Those who had traveled by airplane were asked to report the rate they used and activated the 3 types of security machines (millimeter wave scanners, walkthrough metal detectors, and handheld metal detecting wands). Travelers were also asked about difficulty performing the arm raise, travel delays, inconvenience, and TSA PreCheck. A total of 138 patients traveled since their shoulder replacement. The overall activation rate of the millimeter wave scanner was significantly less than that of the walkthrough and handheld metal detectors (37.3% vs. 47.5% vs. 43.6%, respectively) and decreased with increasing body mass index. Travelers with reverse total shoulder replacements and hemiarthroplasty reported significantly more difficulty performing the arm raise compared with travelers with anatomic total shoulder replacements ( P ≤ .001) but did not travel less nor experience greater delays in traveling ( P > .05). Travelers with TSA PreCheck did not activate machines less frequently nor experience fewer delays, but the majority still recommended the service due to reported decreased hassle. There were no significant differences between activation rates and inconvenience levels, stress, and experienced delays ( P > .05). The introduction of full-body scanners and quality-of-life factors such as TSA PreCheck over the past decade appears to have greatly improved travelers' experiences at airport security. Modern airport security checkpoints are not a significant barrier to travel for patients with shoulder replacements.