Reverse Shoulder Arthroplasty in Weight-Bearing Shoulders of Wheelchair-Dependent Patients: Outcomes and Complications at 2 to 5 years
| Autor: | Eduard Alentorn-Geli, Nathan Wanderman, Andrew T. Assenmacher, Joaquin Sanchez-Sotelo, Robert H. Cofield, John W. Sperling |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Reoperation medicine.medical_specialty Joint replacement Shoulders Minnesota medicine.medical_treatment Elbow Physical Therapy Sports Therapy and Rehabilitation medicine.disease_cause Rotator Cuff Injuries Weight-bearing Weight-Bearing 03 medical and health sciences Postoperative Complications 0302 clinical medicine medicine Humans Rotator cuff Range of Motion Articular Aged Retrospective Studies 030222 orthopedics Shoulder Joint business.industry Arthritis Incidence Rehabilitation Retrospective cohort study 030229 sport sciences Arthroplasty Surgery Cross-Sectional Studies Treatment Outcome medicine.anatomical_structure Wheelchairs Neurology Arthroplasty Replacement Shoulder Physical therapy Female Neurology (clinical) business Range of motion Follow-Up Studies |
| Zdroj: | PM&R. 10:607-615 |
| ISSN: | 1934-1482 |
| Popis: | Background Wheelchair-dependent patients rely on their upper extremities for mobility and transfers. This entails the heavy use of upper extremities as weight-bearing joints, leading to shoulder overuse with increased prevalence of rotator cuff–related disorders and ultimately to challenging cases for shoulder surgeons when a joint replacement is needed. Objective To report the outcomes of reverse shoulder arthroplasty (RSA) in wheelchair-dependent patients with arthritis and rotator cuff tears. Design Retrospective case series/cross-sectional study. Setting Tertiary university hospital. Patient (participants) All wheelchair-dependent patients undergoing RSA between 2004 and 2013. Methods/Interventions Of the 22 wheelchair-dependent patients undergoing RSA, 18 of them had a minimum follow-up of 2 years. There were 9 men and 9 women, with a mean (standard deviation) age and length of follow-up of 68 (8.5) years and 36 (24-63) months. A retrospective chart review and cross-sectional phone calls were conducted to obtain all data. Outcomes Pain, range of motion, functional scores (Neer scale, simple shoulder test, and American Shoulder and Elbow Society), satisfaction, complications/reoperations, radiographic loosening, and 90-day mortality/morbidity. Results RSA resulted in a significant improvement in pain ( P = .02) and nonsignificant improvements in forward flexion ( P = .3) and external rotation ( P = .07). There were 3 (16%) excellent, 12 (63%) satisfactory, and 4 (21%) unsatisfactory results. The mean (standard deviation) postoperative American Shoulder and Elbow Society score was 56.5 (16.5). All patients stated that they would undergo RSA again. There were no surgically related complications or reoperations. The 90-day mortality and morbidity rates were 0% and 26%, respectively. Conclusions RSA is a safe and effective procedure in wheelchair-dependent patients who use their shoulders for weight-bearing purposes. Although functional scores are not optimal and medical complications are not uncommon, 79% of patients had an excellent or satisfactory result. Level of Evidence III |
| Databáze: | OpenAIRE |
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