Clinical Outcome of Arthroscopic Rotator Cuff Repair in Patients Aged 70 Years and Older

Abstract

AIM: The purpose of this study was to evaluate the outcome of arthroscopic rotator cuff repair in patients aged 70 years or older and report our results in terms of pain, range of motion, muscle strength, and functional outcome. MATERIALS AND METHODS: We performed retrospective data review and identified 97 shoulders (94 patients) of our interest with minimum 24 months of follow-up. All patients were evaluated with Visual Analogue Scale (VAS), Range of motion (ROM), Manual Muscle Strength, and Oxford Shoulder Score (OSS) preoperatively and at final follow-up. Patient satisfaction was determined by asking patients whether they were satisfied (yes or no). Statistical analysis was performed using paired t test to compare pre and postoperative measures and Mann-Whitney U test to see the effect of age and gender on the final outcome. RESULTS: Of 97 shoulders, 70 (67.9%) shoulders were available for final evaluation with a mean age of 73.56 years (70 to 81) and mean follow-up of 57.52 months (24 to 122). Mean VAS for pain was improved from 8.4 (6 to 10) to 1.04 (0 to 5) (p < 0.001) at final follow-up. Mean forward flexion, abduction, external rotation increased from 112.50º to 165.43º (p < 0.001), 114.36º to 166.86º (p < 0.001), 45.14º to 73.64º (p < 0.001) respectively, as well as, Internal rotation also improved in 55 patients (78.5%, n = 70) at final followup. Mean muscle strength of Supraspinatus (SSP) and Infraspinatus (ISP) according to MRC scale was significantly improved (p < 0.05) from 2.84 (2 to 4) to 4.67 (4 to 5) and from 2.77 (2 to 4) to 4.64 (3 to 5) at the final follow-up respectively. Mean OSS was improved from 11.49 to 44.40 (p < 0.001) and only three patients (4.28%, n = 70) were subjectively less than satisfied at final follow-up. CONCLUSIONS: There was a significant improvement in shoulder function with a low complication rate. Hence, we have no hesitation to recommend repair in this age group. Provided the rotator cuff is not grossly wasted, and patient is fit to undergo surgery, age should not be the criteria for determining repairability.

Effect of A nursing Rehabilitation Program on Shoulder Joint range of motion and Functional Abilities for Patients Post Rotator Cuff Surgery

“…This can be attributed to overuse of the shoulder, such as repetitive shoulder movements during performing domestic activities, or on the job like manual work such as construction workers and carpenters, which puts strain on the shoulder, stresses muscles and tendons, and results in tendons wear down and causing a tear. This finding agrees with Hattrup, (2018); Babhulkar, Ravikumar, Patil, Kumar, (2019), who out a study entitled "Clinical outcome of arthroscopic rotator cuff repair in patients aged 50 years and older" which reported that tendons lose its strength and flexibility over 40 years old. This makes the ligaments more prone to partial or full thickness tears, and older people are predisposed to complete tears, which can be associated with a higher risk of tendon degeneration and increased difficulty of repair.…”