Rotator cuff repair in patients over 70 years of age

Robinson, PM; Wilson, Joseph B.; Dalal, Sushila; Parker, R.; Norburn, Peter; Roy, Biswajit

doi:10.1302/0301-620x.95b2.30246

Cited by 85 publications

(52 citation statements)

References 47 publications

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“…16,35 Therefore, the negative effect of injections on clinical outcomes in the case of rotator cuff repair could not be explained by the sole toxicity on the tendon itself. 28 In the present study, we found a significant improvement of clinical objective scores at follow-up and a 7% retear rate. No immediate postoperative complication was identified, but 1 patient needed a revision surgery because of a tendon retear associated with poor outcomes.…”

Section: Discussionsupporting

confidence: 70%

“…17,23 It was highlighted that biologic parameters as well as epidemiologic and histomorphometric features were significant prognosis factors. 5,18,21,[23][24][25]28,36 In fact, cells coming from the footprint initiate the healing process, and investigating microvascularization of the footprint is a way to evaluate the biologic power of the bone. 3,14,17,23,33 Ficklscherer et al 10 reported that radiofrequency burning of the footprint commonly performed to clean the reinsertion site of the tendon results in poor histologic and biomechanical outcome.…”

Section: Discussionmentioning

confidence: 99%

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Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

Bonnevialle

Bayle

Faruch

et al. 2015

Journal of Shoulder and Elbow Surgery

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Section: Discussionsupporting

confidence: 70%

Section: Discussionmentioning

confidence: 99%

Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

Bonnevialle

Bayle

Faruch

et al. 2015

Journal of Shoulder and Elbow Surgery

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“…Flurin et al23) reported improvement from a preoperative Constant score of 44 to 76 postoperatively and an American Shoulder and Elbow Surgeons (ASES) score of 35 to 54 postoperatively at 1 year of follow-up in patients ≥ 70 years of age. Robinson et al24) evaluated the arthroscopic rotator cuff repair of 68 patients ≥ 70 years of age. They reported an improved Constant score from 23 preoperatively to 58 at the final follow-up in patients ≥ 70 years of age.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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BackgroundSome 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.MethodsTwenty-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.ResultsOf 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).ConclusionsThere 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.

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“…Studies have implicated male sex, older age, and larger initial tear size as risk factors for recurrent rotator cuff tears. 12 , 15 …”

Section: Discussionmentioning

confidence: 99%

“… 2 , 5 , 11 However, a variety of factors such as patient age and initial tear size are risk factors for recurrent tears. 12 , 15 …”

mentioning

confidence: 99%

A Comparison of Rehabilitation Methods After Arthroscopic Rotator Cuff Repair

Villacis

Yalamanchili

et al. 2015

Sports Health: A Multidisciplinary Approach

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Context:Despite the significant attention directed toward optimizing arthroscopic rotator cuff repair, there has been less focus on rehabilitation after rotator cuff repair surgery.Objective:To determine the effect of different rehabilitation protocols on clinical outcomes by comparing early versus late mobilization approaches and continuous passive mobilization (CPM) versus manual therapy after arthroscopic rotator cuff repair.Data Sources:PubMed was searched for relevant articles using the keywords rotator cuff, rotator, cuff, tears, lacerations, and rehabilitation to identify articles published from January 1980 to March 2014.Study Selection:Inclusion criteria consisted of articles of level 1 or 2 evidence, written in the English language, and with reported outcomes for early versus late mobilization or rehabilitation with CPM versus manual therapy after primary arthroscopic rotator cuff repair. Exclusion criteria consisted of articles of level 3, 4, or 5 evidence, non-English language, and those with significantly different demographic variables between study groups. Included studies were evaluated with the Consolidated Standards of Reporting Trials criteria.Study Design:Systematic review.Level of Evidence:Level 2.Data Extraction:Level of evidence, study type, number of patients enrolled, number of patients at final follow-up, length of follow-up, age, sex, rotator cuff tear size, surgical technique, and concomitant operative procedures were extracted from included articles. Postoperative data included clinical outcome scores, visual analog score for pain, shoulder range of motion, strength, and rotator cuff retear rates.Results:A total of 7 studies met all criteria and were included in the final analysis. Five studies compared early and late mobilization. Two studies compared CPM and manual therapy.Conclusion:In general, current data do not definitively demonstrate a significant difference between postoperative rotator cuff rehabilitation protocols that stress different timing of mobilization and use of CPM.

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Rotator cuff repair in patients over 70 years of age

Cited by 85 publications

References 47 publications

Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

Does microvascularization of the footprint play a role in rotator cuff healing of the shoulder?

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

A Comparison of Rehabilitation Methods After Arthroscopic Rotator Cuff Repair

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