Living With Polio

Rotator Cuff Surgery

Post-Polio Health, Volume 27, Number 3, Summer 2011
Ask Dr. Maynard
Frederick M. Maynard, MD

Question: I have a severe rotator cuff tear and an orthopedic surgeon has recommended a shoulder replacement because of the severity of the tear and the presence of significant arthritis. I had polio in my right leg and use my left leg to lift/stabilize myself on crutches.

Apparently the increased dependency has weakened my arms and, perhaps, injured them. The surgery may help or may create complications. Can you share any knowledge to help me make an informed decision?

Answer:  You raise several important issues related to the pros and cons of shoulder replacement in polio survivors. First of all, if you never had any significant residual weakness in your shoulder muscles as part of your original polio, then it is unlikely that your shoulder problems are, anatomically at least, related to polio. You may have worn them out and/or injured them as you suggested, and the shoulder problem can be surgically treated like anyone else’s.

Definitely get a second opinion about whether the best treatment is arthroplasty (replacement). In addition to a second opinion from a shoulder surgeon specialist, I recommend a second opinion from a non-surgeon, such as a physical medicine and rehabilitation specialist in post-polio. That person cannot only advise about nonsurgical alternatives for the shoulder problem, but also advise you on preparations for the post-operative period, if you do elect to have the shoulder replacement.

Certainly, you should at least practice transferring and walking and caring for yourself with only one arm, since you will not have much use of the arm after surgery for at least three months. You are facing a difficult and important decision. Don’t make a hasty one, especially if you are not suffering severely. Take all steps possible to inform yourself about the pros and cons.

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