title: Arthroscopic rotator cuff repair in the weight-bearing shoulder.
abstract: BACKGROUND
  In wheelchair-dependent individuals, pain often develops because of rotator cuff tendon failure and/or osteoarthritis of the glenohumeral joint. The purposes of this study were to investigate (1) specific rotator cuff tear patterns, (2) structural healing, and (3) clinical outcomes after arthroscopic rotator cuff repair in a cohort of wheelchair-dependent patients.
  
  
  METHODS
  Forty-six shoulders with a mean follow-up of 46 months (range, 24-82 months; SD, 13 months) from a consecutive series of 61 shoulders in 56 patients (46 men and 10 women) undergoing arthroscopic rotator cuff repair were available for analysis. Clinical outcome analysis was performed using the Constant-Murley score, the Subjective Shoulder Value, and the American Shoulder and Elbow Surgeons score. The integrity of the repair was analyzed by ultrasound.
  
  
  RESULTS
  Of the shoulders, 87% had supraspinatus involvement, 70% had subscapularis involvement, and 57% had an anterosuperior lesion involving both the supraspinatus and subscapularis. Despite an overall structural failure rate of 33%, the patients showed improvements in the Constant-Murley score from 50 points (range, 22-86 points; SD, 16 points) preoperatively to 80 points (range, 40-98 points; SD, 12 points) postoperatively and in the American Shoulder and Elbow Surgeons score from 56 points (range, 20-92 points; SD, 20 points) preoperatively to 92 points (range, 53-100 points; SD, 10 points) postoperatively, with a mean postoperative Subjective Shoulder Value of 84% (range, 25%-100%; SD, 17%).
  
  
  CONCLUSIONS
  Failure of the rotator cuff in weight-bearing shoulders occurs primarily anterosuperiorly. Arthroscopic rotator cuff repair leads to a structural failure rate of 33% but satisfactory functional results with high patient satisfaction at midterm follow-up.
authors.affiliation: Swiss Paraplegic Centre Nottwil, Nottwil, Switzerland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Kerr
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Paul
authors.initials: P
authors.lastname: Borbas
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Dominik C
authors.initials: DC
authors.lastname: Meyer
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerber
authors.affiliation: Institute of Radiology, Zofingen Hospital, Zofingen, Switzerland.
authors.forename: Carlos
authors.initials: C
authors.lastname: Buitrago Téllez
authors.affiliation: Department of Orthopaedics, Balgrist University Hospital, University of Zürich, Zürich, Switzerland. Electronic address: karl.wieser@balgrist.ch.
authors.forename: Karl
authors.initials: K
authors.lastname: Wieser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012782:Shoulder / Q000503:physiopathology* / Q000601:surgery; D000070599:Shoulder Injuries; D013708:Tendon Injuries / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D016474:Weight-Bearing
keywords: Arthroscopic rotator cuff repair; rotator cuff; shoulder; subscapularis; supraspinatus; weight-bearing shoulder; wheelchair