Document Detail

Shoulder arthroplasty in the paraplegic patient.
MedLine Citation:
PMID:  19766019     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Shoulder arthroplasty in the paraplegic patient is a challenging procedure, because of the patients' unique demands on the shoulder. Previous information on the outcomes of this surgery in the literature is quite limited. Our experience in the prosthetic reconstruction of the arthritic shoulder in patients with pre-existing paraplegia was reviewed to define the results and identify any complications or the need for revision surgery. METHOD: Six patients were identified as eligible for inclusion. One patient had a humeral head replacement (HHR) and the remaining patients total shoulder arthroplasty (TSA). The average age at time of surgery was 68.7 years. The most common cause of the paraplegia was poliomyelitis, which was present in 3 patients. The other etiologies were transverse myelitis, spina bifida, and familial spastic paraparesis. Patients were followed for an average of 84 months, ranging from a minimum of 24 months up to 200 months. Results were graded according to a modified Neer classification. RESULTS: The results were excellent in 1 shoulder, satisfactory in 4, and unsatisfactory in only 1. One patient continued to have severe pain post-operatively, but good pain relief was achieved in the remaining shoulders. Average postoperative elevation was 122 degrees, ranging from 90 degrees to 150 degrees. Complications included pressure ulceration, pneumonia, brachial plexopathy, and humeral fracture. CONCLUSIONS: Satisfactory outcomes in pain relief and range of motion can be accomplished with shoulder arthroplasty in the paraplegic patient. Complications are frequent and careful management of the patient necessary to minimize their occurrence.
Steven J Hattrup; Robert H Cofield
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-09-18
Journal Detail:
Title:  Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.]     Volume:  19     ISSN:  1532-6500     ISO Abbreviation:  J Shoulder Elbow Surg     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-22     Completed Date:  2010-06-03     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9206499     Medline TA:  J Shoulder Elbow Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  434-8     Citation Subset:  IM    
Copyright Information:
2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.
Department of Orthopedic Surgery, Mayo Clinic Arizona, Phoenix, AZ 85054, USA.
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MeSH Terms
Aged, 80 and over
Arthritis / complications,  surgery*
Arthroplasty, Replacement
Follow-Up Studies
Middle Aged
Paraplegia / complications*,  etiology
Shoulder Joint / surgery*

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