Clin Orthop Surg.  2016 Dec;8(4):420-427. 10.4055/cios.2016.8.4.420.

Rotator Cuff Repair in Patients over 75 Years of Age: Clinical Outcome and Repair Integrity

• Park JG
• Cho NS
• Song JH
• Baek JH
• Jeong HY
• Rhee YG

• KMID: 2412325
• DOI: http://doi.org/10.4055/cios.2016.8.4.420

Abstract

BACKGROUND
Some studies have shown significant functional improvement after rotator cuff (RC) repair in elderly patients. However, few studies have reported the healing potential of RC tears in elderly patients.
METHODS
Twenty-five patients aged ≥ 75 years who underwent RC repair were enrolled. The mean age at the time of surgery was 78.3 years (range, 75 to 88 years) while the mean follow-up was 36.3 months (range, 18 to 114 months). We evaluated clinical and structural outcomes after RC repair in the retear and healed groups.
RESULTS
Of 25 patients, 16 (64%) had healed RC lesions and 9 (36%) had retorn cuff lesions. The retear rate increased significantly with increasing initial tear size (small to medium, 13%; large, 60%; massive, 80%; p = 0.024) but not with increasing age (p = 0.072). The mean visual analog scale (VAS), University of California Los Angeles (UCLA), and Constant scores significantly improved from 5.2, 15.8, and 49.3 preoperatively to 1.4, 31.1, and 71.9 in the healed group and from 6.0, 14.4, and 39.5 preoperatively to 2.4, 28.3, and 63.6 in the retear group at the final follow-up (p < 0.05, respectively). There were no significant differences in clinical outcomes between the 2 groups at the final follow-up. Retear was significantly correlated with initial tear size (p = 0.001; odds ratio [OR], 2.771; 95% confidence interval [CI], 1.394 to 5.509 for large to massive tears) (p = 0.001; OR, 0.183; 95% CI, 0.048 to 0.692 for small to medium tears).
CONCLUSIONS
There were significant improvements in clinical outcomes after RC repair in patients ≥ 75 years. Structural integrity after cuff repair did not affect the final clinical outcome. Even in elderly patients aged ≥ 75 years, healing of repaired RC can be expected in cases of small to medium tears. Although the retear rate was relatively high for large to massive tears, clinical outcomes still showed significant improvement.

Keyword

Shoulder; Rotator cuff; Aged; Treatment outcome

MeSH Terms

Aged
Aged, 80 and over
Female
Humans
Male
Muscle Strength
Pain Measurement
Range of Motion, Articular
Retrospective Studies
Rotator Cuff/*surgery
Rotator Cuff Injuries/*surgery
Shoulder Joint/*surgery
Shoulder Pain
Treatment Outcome

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