Clin Orthop Surg.  2017 Mar;9(1):77-82. 10.4055/cios.2017.9.1.77.

Outcomes of Rotator Cuff Repair in Patients with Comorbid Disability in the Extremities

• Oh JH
• Kim W
• Kim JY
• Rhee YG

• KMID: 2412307
• DOI: http://doi.org/10.4055/cios.2017.9.1.77

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.

Keyword

Rotator cuff; Disability; Paralysis; Treatment outcome

MeSH Terms

Aged
Amputation
Comorbidity
Crutches/adverse effects
Female
Hemiplegia/*epidemiology
Humans
Lower Extremity
Magnetic Resonance Imaging
Male
Middle Aged
Muscle Weakness/*epidemiology
Pain Measurement
Paraplegia/*epidemiology
Range of Motion, Articular
Recurrence
Rotator Cuff Injuries/complications/diagnostic imaging/*epidemiology/*surgery
Shoulder Joint/diagnostic imaging/physiopathology
Shoulder Pain/etiology/surgery
Treatment Outcome
Ultrasonography
Upper Extremity

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