Wheelchair Users Are More Likely to Be Readmitted After a Total Shoulder Replacement

Man with shoulder pain. Wheelchair users are nearly three times more likely than non-wheelchair users to be readmitted to the hospital following a total shoulder replacement surgery. 

According to a new study, wheelchair users are nearly three times more likely than non-wheelchair users to be readmitted to the hospital following a total shoulder replacement surgery. 

In addition to higher rates of readmission, the researchers found that many more wheelchair users had multiple physical conditions before surgery and complications after surgery. Both of these can contribute to readmission.

The findings show that it’s important for wheelchair users, who have a higher-than-average risk of shoulder problems, to seek comprehensive preoperative counseling and risk assessments before undergoing total shoulder replacement.

“The implications of this research are far-reaching, as it directly impacts a growing population of individuals who rely on wheelchairs for mobility,” says lead researcher Yen-Sheng Lin, assistant professor of orthopedic surgery and physical medicine & rehabilitation at UT Southwestern Medical Center, where the study was conducted.

The findings were published in the Journal of Clinical Medicine.

More Health Conditions and Post-Surgery Complications

Researchers reviewed a national database to identify patients diagnosed with a rotator cuff tear who underwent total shoulder replacement between 2010 and 2020. They identified patients who were prescribed a wheelchair and created two groups of 869 patients each: wheelchair users and non-wheelchair users.

The study found that wheelchair users had higher rates of various health problems before surgery, which placed them at greater risk of complications and readmission.

For example, wheelchair users had nearly three times the rate of anemia and heart disease. They also had twice the rate of pulmonary heart disease, myocardial infarction, chronic kidney disease, rheumatoid arthritis, and previous arrhythmias.

Wheelchair users also fared poorly after surgery compared to non-wheelchair users. 

Shoulder dislocation and infection are the leading causes of readmission after total shoulder replacement for non-wheelchair users. But Lin and his colleagues found that urinary tract infections, acute kidney injury, pneumonia, and complications with surgical wounds were the leading causes of readmission for wheelchair users.

Hope for Better Outcomes and Quality of Life

By identifying and addressing the unique challenges wheelchair users face following a total shoulder replacement, health care providers can work toward improving patient outcomes and enhancing quality of life.

“Our research findings have illuminated critical disparities in surgical outcomes for wheelchair users undergoing total shoulder [replacement],” Dr. Lin says. “These insights emphasize the need for tailored preoperative assessments, specialized postoperative care, and informed decision-making discussions for this patient population.”

Of course, the best outcome is not to need a shoulder replacement at all. Stay tuned for posts on how to take care of the shoulders you were born with, including key stretches and strengthening exercises. TwP

Source: Readmissions more likely for wheelchair users after shoulder replacement

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