title: Outcomes of Rotator Cuff Repair in Patients with Comorbid Disability in the Extremities.
abstract: BACKGROUND
  Rehabilitation and overuse of the shoulder after rotator cuff repair are a concern in patients with comorbid disability in other extremities. Improvement of outcomes can be hampered in this situation. This study was to describe the clinical outcomes of rotator cuff repair in patients with comorbid disability in other extremities.
  
  
  METHODS
  In two tertiary institutions, 16 patients with comorbid disability (9 men and 7 women; mean age of 57.1 years [range, 45 to 71 years]; 14 dominant arms; mean follow-up of 18 months [range, 12 to 38 months]) underwent rotator cuff repair. There were 5 massive tears, 1 large tear, 9 medium tears, and 1 small tear. Open repair was performed in 3 patients and arthroscopic repair in 13. The most common comorbid condition was paralysis (n = 7). Eight patients walked with crutches preoperatively. Anatomical outcome was investigated in 12 patients using either magnetic resonance imaging or ultrasonography at least 6 months postoperatively.
  
  
  RESULTS
  Range of motion, visual analogue scale for pain and satisfaction, and all functional scores improved significantly. Healing failure occurred in 4 patients (2 large-to-massive and 2 medium size tears), but none required revision surgery. All 4 retears involved the dominant side, and 3 patients were crutch users.
  
  
  CONCLUSIONS
  The current data suggested favorable outcome of rotator cuff repair in patients with comorbid disability. Careful surgical planning and rehabilitation is particularly important for crutch users and in the case of dominant arm involvement in disabled patients.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea.
authors.forename: Joo Han
authors.initials: JH
authors.lastname: Oh
authors.affiliation: Department of Orthopedic Surgery, Nalgae Hospital, Seoul, Korea.
authors.forename: Woo
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Jung Youn
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Kyung Hee University College of Medicine, Seoul, Korea.
authors.forename: Yong Girl
authors.initials: YG
authors.lastname: Rhee
mesh_terms: D000368:Aged; D000671:Amputation, Surgical; D015897:Comorbidity; D003446:Crutches / Q000009:adverse effects; D005260:Female; D006429:Hemiplegia / Q000453:epidemiology*; D006801:Humans; D035002:Lower Extremity; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness / Q000453:epidemiology*; D010147:Pain Measurement; D010264:Paraplegia / Q000453:epidemiology*; D016059:Range of Motion, Articular; D012008:Recurrence; D000070636:Rotator Cuff Injuries / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology; D020069:Shoulder Pain / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014463:Ultrasonography; D034941:Upper Extremity
keywords: Disability; Paralysis; Rotator cuff; Treatment outcome