AI Article Synopsis
- Wheelchair-dependent patients often experience shoulder issues due to the stress on their upper extremities from mobility activities, leading to rotator cuff disorders that may require shoulder replacement surgery.
- This study evaluated the outcomes of reverse shoulder arthroplasty (RSA) in these patients, focusing on factors like pain relief, range of motion, and patient satisfaction after surgery.
- The results showed significant pain improvement and overall satisfaction with the procedure, indicating RSA is a viable option for enhancing quality of life in this patient population, with low complication rates post-surgery.
Article Abstract
Background: Wheelchair-dependent patients rely on their upper extremities for mobility and transfers. This entails the heavy use of upper extremities as weight-bearing joints, leading to shoulder overuse with increased prevalence of rotator cuff-related disorders and ultimately to challenging cases for shoulder surgeons when a joint replacement is needed.
Objective: To report the outcomes of reverse shoulder arthroplasty (RSA) in wheelchair-dependent patients with arthritis and rotator cuff tears.
Design: Retrospective case series/cross-sectional study.
Setting: Tertiary university hospital.
Patient (participants): All wheelchair-dependent patients undergoing RSA between 2004 and 2013.
Methods/interventions: Of the 22 wheelchair-dependent patients undergoing RSA, 18 of them had a minimum follow-up of 2 years. There were 9 men and 9 women, with a mean (standard deviation) age and length of follow-up of 68 (8.5) years and 36 (24-63) months. A retrospective chart review and cross-sectional phone calls were conducted to obtain all data.
Outcomes: Pain, range of motion, functional scores (Neer scale, simple shoulder test, and American Shoulder and Elbow Society), satisfaction, complications/reoperations, radiographic loosening, and 90-day mortality/morbidity.
Results: RSA resulted in a significant improvement in pain (P = .02) and nonsignificant improvements in forward flexion (P = .3) and external rotation (P = .07). There were 3 (16%) excellent, 12 (63%) satisfactory, and 4 (21%) unsatisfactory results. The mean (standard deviation) postoperative American Shoulder and Elbow Society score was 56.5 (16.5). All patients stated that they would undergo RSA again. There were no surgically related complications or reoperations. The 90-day mortality and morbidity rates were 0% and 26%, respectively.
Conclusions: RSA is a safe and effective procedure in wheelchair-dependent patients who use their shoulders for weight-bearing purposes. Although functional scores are not optimal and medical complications are not uncommon, 79% of patients had an excellent or satisfactory result.
Level Of Evidence: III.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.pmrj.2017.10.010 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Management of Cardiac Involvement in Becker Muscular Dystrophy: A Case Report.
Cureus
November 2024
Cardiovascular Disease, University Hospital Center "Mother Teresa", Tirana, ALB.
Becker muscular dystrophy (BMD) is an X-linked recessive neuromuscular disorder caused by a mutation in the dystrophin gene. Cardiac involvement is a frequent finding in BMD, and manifestations may vary from asymptomatic cardiac involvement to developing symptoms of heart failure and severe cardiomyopathy. We presented the case of a 32-year-old wheelchair-dependent BMD patient who came to our cardiology clinic with a two-month history of heart palpitations, rest and nocturnal dyspnea, fatigue, and generalized muscular weakness.
View Article and Find Full Text PDFTracheobronchoplasty for severe tracheobronchomalacia: a case-series of patients with acute and chronic critical comorbidities.
Interdiscip Cardiovasc Thorac Surg
September 2024
Department of Cardiovascular and Thoracic Surgery, West Virginia University, Morgantown, WV, USA.
Objectives: There are little data within the literature regarding tracheobronchoplasty in the setting of the acute and chronically ill, morbidly obese or ventilator-dependent patients with tracheobronchomalacia. Short- and long-term outcomes are studied.
Methods: The series represents 12 tracheobronchomalacia patients with American Society of Anesthesiologists (ASA) physical status scores of 3-5.
Wheelchair dependence in patients with dementia: Focus on kinematic gait analysis using simple wearable accelerometers and gyroscopes.
Assist Technol
October 2024
Department of Psychiatry, Sekiaikai Yokohama Maioka Hospital, Yokohama, Japan.
Falls, wheelchair dependence, and bedridden status are the results of reduced mobility in the mid-late course of dementia. Kinematic gait analysis for patients with dementia is lacking because practically setting sensors on their bodies is particularly difficult. We analyzed the parameters of kinematic gait analysis that are related to the risks of wheelchair dependence in patients with dementia using wearable accelerometers and gyroscopes for detecting 3-dimensional physical movements.
View Article and Find Full Text PDFPerioperative management and outcomes for posterior spinal fusion in patients with Friedreich ataxia: A single-center, retrospective study.
Paediatr Anaesth
July 2024
Department of Anesthesiology and Critical Care Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Article Synopsis
- Friedreich ataxia is a rare genetic disorder causing mitochondrial dysfunction, leading to issues like ataxia, muscle weakness, and complications during surgeries, particularly posterior spinal fusion in children.
- This study at the Children's Hospital of Philadelphia involved 17 adolescent patients, assessing their perioperative management and outcomes during spinal deformity surgery over a 16-year span.
- Results showed high postoperative complication rates (88%), with common issues including nausea/vomiting and severe cases requiring extracorporeal membrane oxygenation, highlighting the need for careful perioperative management in these patients.
Long-term clinical follow-up of a family with Becker muscular dystrophy associated with a large deletion in the DMD gene.
Neuromuscul Disord
June 2024
West Midlands Regional Genetics Service, Birmingham Women's and Children's Hospital, Birmingham B15 2TG, United Kingdom. Electronic address:
Duchenne muscular dystrophy is a neuromuscular disease caused by DMD gene mutations that result in an absence of functional dystrophin protein. Patients with Duchenne experience progressive muscle weakness, are typically wheelchair dependent by their early teens, and develop respiratory and cardiac complications that lead to death in their twenties or thirties. Becker muscular dystrophy is also caused by DMD gene mutations, but symptoms are less severe and progression is slower compared with Duchenne.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!