Reconstruction of rotator cuff tears in wheelchair-bound paraplegic patients.
BACKGROUND
Rotator cuff surgery in wheelchair-bound patients is challenging, and clinical data on this condition are limited. We hypothesized that rotator cuff repair in these patients might improve functional outcomes.


METHODS
In a retrospective study, data on 13 paraplegic patients (8 men and 5 women; 16 shoulders) who underwent rotator cuff repair were analyzed. The average age at the time of surgery was 48.7 years. The causes of paraplegia were poliomyelitis in 9 patients, spinal fracture in 4, and cerebral infarction in 2. Open rotator cuff repair was performed in 11 patients and arthroscopic repair in 2 patients. No wheelchair propulsion was allowed until 6 months postoperatively to protect the repaired cuffs. American Shoulder and Elbow Surgeons (ASES) score and Constant score were used for functional evaluation. To assess tendon integrity, magnetic resonance imaging or ultrasonography was used at an average of 31.2 months postoperatively.


RESULTS
ASES scores improved from 53 to 85, and Constant scores improved from 48 to 75. Radiographic evaluation revealed healing in 88% of the cases and retear in 12%. In the retear group, functional scores improved.


CONCLUSION
Rotator cuff repair surgery for paraplegic wheelchair-bound patients provides satisfactory functional outcomes. Careful postoperative management can help in obtaining positive functional outcomes.
['Jung|Hong Jun|HJ|', 'Sim|Gyeong-Bo|GB|', 'Jeon|In-Ho|IH|', 'Kekatpure|Aashay L|AL|', 'Sun|Ji-Ho|JH|', 'Chun|Jae-Myeung|JM|']
D000328:Adult D000368:Aged D005260:Female D006801:Humans D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D053580:Muscle Strength D010264:Paraplegia D016059:Range of Motion, Articular D012008:Recurrence D012189:Retrospective Studies D017006:Rotator Cuff D000070636:Rotator Cuff Injuries D012782:Shoulder D012785:Shoulder Joint D013708:Tendon Injuries D016896:Treatment Outcome D014910:Wheelchairs D014945:Wound Healing
Rotator cuff tear wheelchair-bound paraplegic patients paraplegia