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Rotator Cuff Repair in Spinal Cord Injury Patients

Authors: RL Popowitz et al.

References: Presented at AAOS 2003

Abstract
Previous studies concerning rotator cuff tears in wheelchair bound patients concentrated on non-surgical treatment. We conducted a prospective study to determine the effectiveness of surgical intervention of rotator cuff tears in spinal cord injured patients. Five male patients, mean age of 49.8, with rotator cuff tears confirmed by physical examination and magnetic resonance imaging, underwent rotator cuff repair. Two of 8 shoulders were revisions. The patients were evaluated postoperatively using the American Shoulder and Elbow Surgeons' Shoulder Score Index. These results were compared to preoperative functional assessment. Patients were given a subjective questionnaire to assess their overall experience. During follow-up examination an average of 3.5 years postoperatively (range 1.5 - 6 years), range of motion had improved in 6 of 8 shoulders. Strength was increased in 6 of 8 shoulders. The American Shoulder and Elbow Surgeons' Shoulder Score Index improved from a preoperative mean of 34.1 (range 21.7 - 61.7) to a postoperative mean of 84.3 (range 58.4 - 100). Patients reported satisfaction with the results in 7 of 8 shoulders, and claimed to have returned to pre-injury levels of function. All 5 patients would recommend the procedure to other spinal cord injury patients. Surgical intervention for spinal cord injury patients with rotator cuff tears can improve the their functional capability and autonomy while reducing their pain. Compliance with the demanding postoperative rehabilitation is essential, therefore proper patient selection is crucial for optimal results.

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