Shoulder complaints and incidence of shoulder pathologies after contralateral major amputation in the mid and long-term

Rausch, Valentin, Heider, Maximilian, Heute, Christoph, Rosteius, Thomas, Seybold, Dominik, Gessmann, Jan, Schildhauer, Thomas A. and Koenigshausen, Matthias . Shoulder complaints and incidence of shoulder pathologies after contralateral major amputation in the mid and long-term. Arch. Orthop. Trauma Surg.. NEW YORK: SPRINGER. ISSN 1434-3916

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DOI:10.1007/s00402-022-04720-x

Abstract

Introduction Amputations of the upper extremity are rare but present a life-altering event that is accompanied with considerable restrictions for the affected patients. Even with functional prosthesis, tasks of the amputated limb are usually transferred to the unaffected arm which could result in complaints of the unaffected shoulder in the mid and long term. We therefore aimed to investigate musculoskeletal pain and morphological degenerative changes of the shoulder following a contralateral amputation. Materials and methods We included all patients with a major amputation treated at our institution with a minimum of three years since the amputation. All patients received an MRI of both shoulders and were investigated using validated scores for the upper extremity and physical activity (SSV, ASES, DASH, GPAQ, SF-36). Results of the MRIs were investigated for morphological changes by two blinded investigators comparing the side of the amputation and the unharmed upper extremity and results were correlated to the time since amputation and their physical activity. Results A total of 20 patients with a mean age of 56 +/- 19.9 years (range, 23-82 years) could be included in the study. The mean time since the amputation was 26.3 +/- 19 years (range, 3-73 years). On the unharmed upper extremity, the mean SSV was 61.9 +/- 24.6, the mean ASES-Score 54.5 +/- 20.3, the Constant-score of 63.7 +/- 40.4 and a DASH-score of 47.6 +/- 23.8. The MRI of the unharmed shoulder showed significant more full-thickness rotator cuff tears and joint effusion compared to the side of the amputation. Significant differences in the degree of a glenohumeral arthritis, AC-joint arthritis, or partial rotator cuff tears could not be found between shoulders. Conclusion Amputations of the upper extremity are associated with a high disability of the unharmed upper extremity and more full thickness rotator cuff tears compared to the side of the amputation. However, the small number of patients and rotator cuff injuries should be kept in mind when interpreting the data.

Item Type:

Journal Article

Creators:

Creators	Email	ORCID	ORCID Put Code
Rausch, Valentin	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Heider, Maximilian	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Heute, Christoph	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Rosteius, Thomas	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Seybold, Dominik	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Gessmann, Jan	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Schildhauer, Thomas A.	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED
Koenigshausen, Matthias	UNSPECIFIED	UNSPECIFIED	UNSPECIFIED