The magnetic resonance imaging examination results of 200 shoulders in each group were analyzed. Clinical examination included the Constant score and a visual analog scale for pain intensity.
The prevalence of RCTs was 63 % in paraplegic patients versus 15 % in able-bodied volunteers (P?< .0001). All RCTs in the paraplegic group were associated with symptoms. Among the patients with RCTs, full-thickness tears were detected in 78 % of cases in the paraplegic patient group versus 73 % of cases in the volunteer group. The rate of partial-thickness tears was 22 % in the paraplegic group versus 27 % in the volunteer group. Paraplegic patients had a lower Constant score; Disabilities of the Arm, Shoulder and Hand score; and range of motion and a higher pain intensity than the volunteer cohort. The mean tear width in paraplegic patients was 14.4 mm (range, 8-28 mm) versus 9.9 mm (range, 8-14 mm) in the volunteers (P < .01).
The etiology of RCTs in paraplegic patients seems to be based on wear-and-tear mechanisms rather than aging. These results are important for our understanding of shoulder pathology in long-term paraplegic patients and show the impact of this problem.