title: Reconstruction of rotator cuff tears in wheelchair-bound paraplegic patients.
abstract: 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.
  
  
  CONCLUSIONS
  Rotator cuff repair surgery for paraplegic wheelchair-bound patients provides satisfactory functional outcomes. Careful postoperative management can help in obtaining positive functional outcomes.
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Jung
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Gyeong-Bo
authors.initials: GB
authors.lastname: Sim
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea. Electronic address: jeonchoi@gmail.com.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Aashay L
authors.initials: AL
authors.lastname: Kekatpure
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Ji-Ho
authors.initials: JH
authors.lastname: Sun
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, South Korea.
authors.forename: Jae-Myeung
authors.initials: JM
authors.lastname: Chun
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength; D010264:Paraplegia / Q000150:complications; D016059:Range of Motion, Articular; D012008:Recurrence; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000503:physiopathology; D012785:Shoulder Joint / Q000503:physiopathology / Q000601:surgery*; D013708:Tendon Injuries / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome; D014910:Wheelchairs; D014945:Wound Healing
keywords: Rotator cuff tear; paraplegia; paraplegic patients; wheelchair-bound