0
Scientific Articles   |    
Prevalence of Rotator Cuff Tear in Paraplegic Patients Compared with Controls
Michael Akbar, MD1; Gabriel Balean, MD1; Manuela Brunner, BS1; Thorsten M. Seyler, MD2; Thomas Bruckner, PhD3; Judith Munzinger3; Thomas Grieser, MD1; Hans J. Gerner, MD1; Markus Loew, MD4
1 Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Heidelberg, Schlierbacher Landstrasse 200A, 69118 Heidelberg, Germany. E-mail address for M. Akbar: michael.akbar@ok.uni-heidelberg.de
2 Center for Joint Preservation and Replacement, Rubin Institute for Advanced Orthopedics, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215
3 Department of Medical Biometry and Informatics, University of Heidelberg, Im Neuenheimer Feld 305, 69120 Heidelberg, Germany
4 Department of Shoulder and Elbow Surgery, University of Heidelberg, Schlierbacher Landstrasse 200A, 69118 Heidelberg, Germany
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

Investigation performed at the Department of Orthopaedic Surgery and Rehabilitation Medicine, University of Heidelberg, Heidelberg, Germany

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jan 01;92(1):23-30. doi: 10.2106/JBJS.H.01373
5 Recommendations (Recommend) | 3 Comments | Saved by 3 Users Save Case

Abstract

Background: 

Musculoskeletal injuries of the shoulder in paraplegic patients with long-term survival can result from overuse and/or inappropriate use of wheelchairs. The purpose of the present study was to evaluate the prevalence and risk of pathological changes in the weight-bearing shoulder girdle of paraplegic patients who have been wheelchair-dependent for more than thirty years in comparison with able-bodied volunteers.

Methods: 

One hundred paraplegic patients were matched for sex and age with a group of 100 able-bodied volunteers. Two hundred shoulders from each group were evaluated with use of magnetic resonance imaging. Collected outcome measures included a standardized clinical examination protocol, the Constant score, and a visual analog score for pain intensity.

Results: 

Shoulder function according to the Constant score was significantly worse in the paraplegic patients than in the able-bodied volunteers. Similarly, the visual analog scale pain scores were significantly worse for the paraplegic patients. Magnetic resonance imaging showed that the prevalence of rotator cuff tears in either shoulder was significantly higher in the paraplegic patients than in the able-bodied volunteers (63% compared with 15%), resulting in a tenfold higher risk of rotator cuff rupture among paraplegic patients.

Conclusions: 

The present study demonstrates that the structural and functional changes of the shoulder joint are more severe and the risk of development of shoulder girdle damage is significantly higher in individuals with long-term paraplegia than in age-matched controls.

Level of Evidence: 

Prognostic Level III. See Instructions to Authors for a complete description of levels of evidence.

Figures in this Article
    Sign In to Your Personal ProfileSign In To Access Full Content
    Not a Subscriber?
    Get online access for 30 days for $35
    New to JBJS?
    Sign up for a full subscription to both the print and online editions
    Register for a FREE limited account to get full access to all CME activities, to comment on public articles, or to sign up for alerts.
    Register for a FREE limited account to get full access to all CME activities
    Have a subscription to the print edition?
    Current subscribers to The Journal of Bone & Joint Surgery in either the print or quarterly DVD formats receive free online access to JBJS.org.
    Forgot your password?
    Enter your username and email address. We'll send you a reminder to the email address on record.

     
    Forgot your username or need assistance? Please contact customer service at subs@jbjs.org. If your access is provided
    by your institution, please contact you librarian or administrator for username and password information. Institutional
    administrators, to reset your institution's master username or password, please contact subs@jbjs.org

    References

    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
    CME Activities Associated with This Article
    Submit a Comment
    Please read the other comments before you post yours. Contributors must reveal any conflict of interest.
    Comments are moderated and will appear on the site at the discretion of JBJS editorial staff.

    * = Required Field
    (if multiple authors, separate names by comma)
    Example: John Doe





    Related Content
    The Journal of Bone & Joint Surgery
    JBJS Case Connector
    Topic Collections
    Related Audio and Videos
    PubMed Articles
    Clinical Trials
    Readers of This Also Read...
    JBJS Jobs
    04/22/2014
    New York - Columbia University Medical Ctr/Dept of Ortho.Surg
    11/15/2013
    LA - Ochsner Health System
    12/04/2013
    NY - Icahn School of Medicine at Mount Sinai
    03/05/2014
    OK - The University of Oklahoma