Rotator cuff repair in upper extremity ambulators: an assessment of longitudinal outcomes

Valiquette, Andrew M.; Graf, Adam; Mickshl, Dara J.; Zganjar, Andrew J.; Grindel, Steven I.

doi:10.1016/j.jseint.2022.08.015

Cited by 5 publications

(5 citation statements)

References 24 publications

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“…Our analysis further demonstrates that comorbidities such as osteoarthritis, ischemic heart disease, pulmonary heart disease, chronic kidney disease, and previous arrhythmias are also strong predictors of readmission. Several risk factors associated with readmissions following total shoulder arthroplasty in wheelchair users were comparable with non-wheelchair users [ 13 , 15 , 21 ]. Dislocation and infection are the leading causes for readmission following TSA [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical management of this population includes rotator cuff repair, anatomical total shoulder arthroplasty, and reverse total shoulder arthroplasty. Though rotator cuff repairs were historically believed to be ineffective as a treatment option due to an elevated risk of re-tears and complex tear patterns, a recent study has shown some short-term success in performing primary rotator cuff repairs, with significant improvements in pain, range of motion, and strength in wheelchair users [ 13 ]. However, the healing outcomes of primary rotator cuff repairs were significantly lower compared to the healing outcomes in patients who underwent total shoulder arthroplasty [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…Though rotator cuff repairs were historically believed to be ineffective as a treatment option due to an elevated risk of re-tears and complex tear patterns, a recent study has shown some short-term success in performing primary rotator cuff repairs, with significant improvements in pain, range of motion, and strength in wheelchair users [ 13 ]. However, the healing outcomes of primary rotator cuff repairs were significantly lower compared to the healing outcomes in patients who underwent total shoulder arthroplasty [ 13 ]. In addition, total shoulder arthroplasty has been reported to minimize pain and improve functional outcomes, with a slightly higher rate of complications compared to primary rotator cuff repairs [ 4 , 13 , 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, the healing outcomes of primary rotator cuff repairs were significantly lower compared to the healing outcomes in patients who underwent total shoulder arthroplasty [ 13 ]. In addition, total shoulder arthroplasty has been reported to minimize pain and improve functional outcomes, with a slightly higher rate of complications compared to primary rotator cuff repairs [ 4 , 13 , 14 , 15 ]. Previous studies have revealed a higher prevalence of rotator cuff tears and glenohumeral osteoarthritis among individuals in the wheelchair population compared to non-wheelchair users [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…Additionally, predicting outcomes is more challenging due to the distinctive biomechanics involved in wheelchair-specific movements, such as propulsion [ 13 ]. The relationship between the comorbidity of surgical management and postoperative outcomes is crucial for clinical decision-making regarding wheelchair users, yet it remains poorly understood.…”

Section: Introductionmentioning

confidence: 99%

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Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

Prabhu,

Nasr,

Kasitinon

et al. 2023

JCM

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Impaired shoulder function hinders the ability of wheelchair users to maintain independence. The current state of the literature delineates the risks and benefits of surgical techniques for the management of shoulder pathologies. To the best of our knowledge, there is no study that has investigated complications following total shoulder arthroplasty (TSA) in wheelchair users. Utilizing the PearlDiver Mariner national administrative database, 72,108 patients were identified who underwent TSA with a concurrent diagnosis of a rotator cuff tear. Two matched cohorts, one of wheelchair users and one of non-wheelchair users, were created. Due to limitations within PearlDiver, one-year outcomes, including comorbidity and complication rates and readmission statistics, were compared between the two cohorts. Each matched cohort of 869 patients underwent TSA with a concurrent diagnosis of a rotator cuff tear. The rate of readmission in wheelchair users was greater than in non-wheelchair users (24.05% vs. 9.55%, OR: 3.00, CI: 2.279, 3.946). Patients in the wheelchair cohort exhibited higher rates of complications and comorbidities (p < 0.001). Among the most likely to be readmitted after TSA were patients with osteoarthritis, pulmonary heart disease, rheumatoid arthritis, and hypertension (p < 0.05). Significant differences in surgical outcomes existed between wheelchair and non-wheelchair users in terms of preoperative comorbidities, postoperative complications, and readmission rates.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

Prabhu,

Nasr,

Kasitinon

et al. 2023

JCM

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Shoulder arthroplasty in the upper extremity weight-bearing patient: a systematic review of clinical outcomes and complications

Ponce,

Wrenn,

White

et al. 2025

Journal of Shoulder and Elbow Surgery

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Upper Limb Function in People With Upper and Lower Limb Loss 8 Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study

Watson,

Kedgley,

Schofield

et al. 2024

Physical Therapy

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Objective Upper limb (UL) disability in people with UL amputation/s is well reported in the literature, less so for people with lower limb amputation/s. This study aimed to compare UL disability in injured (major trauma) and uninjured UK military personnel, with particular focus on people with upper and lower limb amputation/s. Methods A volunteer sample of injured (n = 579) and uninjured (n = 566) UK military personnel who served in a combat role in the Afghanistan war were frequency matched on age, sex, service, rank, regiment, role, and deployment period and recruited to the Armed Services Trauma Rehabilitation Outcome (ADVANCE) longitudinal cohort study. Participants completed the Disability of the Arm, Shoulder, and Hand (DASH) questionnaire, scored from 0 (no disability) to 100 (maximum disability) 8 years postinjury. Mann–Whitney U and Kruskal Wallis tests were used to compared DASH scores between groups. An ordinal model was used to assess the effect of injury and amputation on DASH scores. Results DASH scores were higher in the group with injuries compared to the group without injuries (3.33 vs 0.00) and higher in people with lower limb loss compared to the group without injuries (0.83 vs 0.00), although this was not statistically significant. In the adjusted ordinal model, the odds of having a higher DASH score was 1.70 (95% CI = 1.18–2.47) times higher for people with lower limb loss compared to the group without injuries. DASH score was not significantly different between people with major and partial UL loss (15.42 vs 12.92). The odds of having a higher DASH score was 8.30 (95% CI = 5.07–13.60) times higher for people with UL loss compared to the uninjured group. Conclusion People with lower limb loss have increased odds of having more UL disability than the uninjured population 8 years postinjury. People with major and partial UL loss have similar UL disability. The ADVANCE study will continue to follow this population for the next 20 years. Impact For the first time, potential for greater upper limb disability has been shown in people with lower limb loss long-term, likely resulting from daily biomechanical compensations such as weight-bearing, balance, and power generation. This population may benefit from prophylactic upper limb rehabilitation, strength, and technique.

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Rotator cuff repair in upper extremity ambulators: an assessment of longitudinal outcomes

Cited by 5 publications

References 24 publications

Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

Perioperative Outcomes, Comorbidities, and Complications following Total Shoulder Arthroplasty in Wheelchair Users: A Retrospective Cohort Analysis of a Nationwide Database

Shoulder arthroplasty in the upper extremity weight-bearing patient: a systematic review of clinical outcomes and complications

Upper Limb Function in People With Upper and Lower Limb Loss 8 Years Postinjury: The Armed Services Trauma Outcome Study (ADVANCE) Cohort Study

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