Clinical outcome and repair integrity after rotator cuff repair in patients older than 70 years versus patients younger than 70 years

Arthroscopy. 2014 May;30(5):546-54. doi: 10.1016/j.arthro.2014.02.006. Epub 2014 Mar 14.

Abstract

Purpose: The purpose of this study was to evaluate and compare the clinical and structural outcomes of rotator cuff repairs in patients older than 70 years and those younger than 70 years and to analyze a correlation between patient factors and retear rate.

Methods: Two hundred thirty-eight patients between the ages of 60 and 79 who underwent rotator cuff repair between 2006 and 2011 and were available for postoperative magnetic resonance imaging (MRI) evaluation at least 6 months after surgery were enrolled in this study. They were divided into 2 groups, one group (n = 191) included patients aged between 60 and 69 years, and the other group (n = 47) included patients aged between 70 and 79 years. The mean follow-up period was 14.6 months (range, 12-63 months) and 13.2 months (range, 12-62 months) for patients in their 60s and 70s, respectively.

Results: The mean visual analog scale (VAS), University of California Los Angeles (UCLA), and Constant scores significantly improved from 5.4, 18.1, and 57.4 preoperatively to 1.0, 31.2, and 75.0 at the final follow-up, respectively (P < .001), in the 60s group and from 5.9, 17.0, and 53.6 to 1.3, 30.1, and 72.7, respectively (P < .001), in the 70s group. There were no significant differences between the 2 groups (P > .05). Instead, intraoperative tear size was correlated with the clinical scores with Pearson correlation coefficients of -0.161 and -0.211 for patients in their 60s and 70s, respectively. There were 76 (39.8%) retears among patients in their 60s and 24 (51.1%) retears among patients in their 70s, with no significant difference between the 2 groups (P = .161). The retear rate increased significantly with increasing preoperative tear size (P < .001; odds ratio [OR], 7.1 in large tears; P < .0001; OR, 17.2 in massive tears). Age and sex were not significantly correlated with the retear rate.

Conclusions: Both patients in their 60s and 70s showed significant improvement in clinical outcomes after rotator cuff repair, without a significant difference between the 2 populations. The retear rate increased significantly with increasing intraoperative tear size but not with increasing age.

Level of evidence: Level III, case-control study.

Publication types

  • Comparative Study
  • Evaluation Study

MeSH terms

  • Age Factors
  • Aged
  • Arthroscopy / methods
  • Case-Control Studies
  • Causality
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Humans
  • Lacerations / diagnosis
  • Lacerations / epidemiology
  • Lacerations / surgery*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Muscle Strength / physiology
  • Pain Measurement
  • Range of Motion, Articular / physiology
  • Retrospective Studies
  • Rotator Cuff / pathology
  • Rotator Cuff / physiopathology
  • Rotator Cuff / surgery*
  • Rotator Cuff Injuries*
  • Shoulder Joint / physiopathology
  • Shoulder Pain / diagnosis
  • Shoulder Pain / epidemiology
  • Tendon Injuries / epidemiology
  • Tendon Injuries / surgery*
  • Treatment Outcome
  • Wound Healing