Open repair of massive rotator cuff tears in patients aged sixty-five years or over: Is it worthwhile?

Lam, Francis; Mok, D.

doi:10.1016/j.jse.2004.02.016

Cited by 83 publications

(53 citation statements)

References 23 publications

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“…The time required for functional recovery reportedly is related to several factors including age [19], rotator cuff tear size [22,30], preoperative muscle weakness [28], and joint mobility [8]. In the literature, the information varies widely regarding the prognostic factors of rotator cuff repair [2,3,11,13].…”

Section: Introductionmentioning

confidence: 99%

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Manaka

Ito

Matsumoto

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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Background Several studies have reported functional recovery of the shoulder after arthroscopic rotator cuff repair (ARCR). Preoperative estimation of the time required for functional recovery is important for determining surgical indications and for planning timing of the surgery and an appropriate postoperative physical therapy. Questions/purposes We therefore asked: (1) how long it takes to obtain functional recovery after ARCR, and (2) what preoperative factors influence functional recovery time. Patients and Methods We retrospectively evaluated 201 patients who had undergone ARCR. Using the Japanese Orthopaedic Association (JOA) shoulder scoring system, we defined the functional recovery period as the time required to achieve a score greater than 80% in each component. We evaluated the functional recovery periods and assessed preoperative influencing factors such as age, gender, shoulder stiffness, morphologic features of rotator cuff tears, and rotator cuff tear size. Results Sixty-three patients (31%) took less than 3 months, 81 patients (40%) took between 3 and 6 months, and 57 patients (28%) took greater than 6 months to achieve a score greater than 80% in each JOA shoulder assessment component. Younger patients without shoulder stiffness and with smaller rotator cuff tears had shorter functional recovery periods. Conclusions One hundred forty-four patients (72%) obtained functional recovery within 6 months after ARCR. Age, shoulder stiffness, and rotator cuff tear size influenced functional recovery time.

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Section: Introductionmentioning

confidence: 99%

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Manaka

Ito

Matsumoto

et al. 2011

Clinical Orthopaedics &Amp; Related Research

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“…Some studies included all tear sizes according to the Cofield classification. 19,36,38,40,42 Lam et al 40 intra-operatively encountered > 5 cm full thickness RCT in all patients (postoperative CSS = 63%). Some studies excluded massive tears (> 5 cm).…”

Section: Inclusion and Exclusion Criteriamentioning

confidence: 91%

“…They hypothesized that patients aged 65 years and above could have tendon healing, and consequently, significant functional improvement. In the study by Lam et al, 40 the purpose was to evaluate functional outcome and identify possible preoperative prognostic factors in patients aged 65 years or more, undergoing repair for a massive (> 5 cm) full-thickness rotator cuff tear. Miyazaki et al 35 33,34 were multicenter prospective studies conducted in 11 surgical centers and presented in the Société Française d'Arthroscopie (French Arthroscopic Society, SFA) symposium in 2012.…”

Section: Study Objectivesmentioning

confidence: 99%

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

Silva¹,

Cartucho²,

Sarmento³

et al. 2017

Acta Med Port

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RESUMOIntrodução: O objetivo deste estudo, é o de analisar a evidência atual no que respeita ao tratamento cirúrgico de roturas da coifa dos rotadores, em doentes com mais de 65 anos de idade. A hipótese proposta foi que o tratamento cirúrgico de roturas da coifa dos rotadores, em doentes com 65 anos ou mais, acarreta bons resultados funcionais. Não existe, na literatura atual, uma revisão sistemática com os mesmos parâmetros que esta. Material e Métodos: Recorremos à Medline ® , PubMed, Scopus, e Cochrane Register of Controlled Trials, na procura de estudos entre janeiro de 1999 e dezembro de 2015, independentemente da língua, que incluíssem as palavras: 'rotator cuff' e '65 years' ou '70 years'. Como critérios de inclusão estipulámos, estudos (nível I a IV) que reportassem os resultados funcionais de doentes com 65 anos ou mais, submetidos à reparação cirúrgica de uma rotura da coifa dos rotadores sintomática. Foram incluídas técnicas artroscópicas, mini-invasivas e abertas. Os critérios de exclusão estipulados foram, estudos que incluíssem doentes com menos de 65 anos, estudos que não recorressem a escalas de avaliação funcional validadas, como ferramenta de aferição primária, e aqueles com tempo de seguimento inferior a um ano. Este trabalho seguiu as orientações da Preferred Reporting Items for Systematic Reviews and Meta-Analyses -PRISMA. A informação colhida incluiu dados demográficos, padrões de rotura, procedimentos cirúrgicos realizados e resultados, clínicos e das reparações efectuadas. Os resultados funcionais foram convertidos em percentagens, permitindo a comparação de dados entre os estudos. Resultados: Quatorze estudos cumpriram os critérios de inclusão: 11 estudos nível IV, um estudo nível III e dois estudos nível II. Sete estudos reportaram melhorias com significado estatístico entra as avaliações funcionais pré e pós operatórias. Todos os estudos reportaram resultados funcionais bons ou excelentes. Discussão: É provável que seriam obtidos resultados mais consistentes, se todos os estudos incluídos tivessem critérios de selecção mais homogéneos e rigorosos. Apesar de tal não se ter verificado, os resultados clínicos foram, todavia, favoráveis. Isto traduziu-se numa melhoria dos resultados funcionais, com significado estatístico, em todos os estudos prospectivos incluídos. Conclusão: Com base na literatura atual, a reparação de roturas da coifa dos rotadores em doentes com 65 anos ou mais, está associada à melhoria dos resultados funcionais e a um bom grau de satisfação com o procedimento. Palavras-chave: Artroscopia; Idoso; Revisão Sistemática; Rotura da Coifa dos Rotadores ABSTRACTIntroduction: The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature. Material and Methods: Medline ® , PubMed, Scopus, and the ...

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“…Most studies evaluate cellular contribution to healing of tendon as significant. In terms of technology application, amount and concentration of the MSCs is still no clear consensus [37][38][39][40].…”

Section: Research Papermentioning

confidence: 99%

Mesenchymal stem cells in the reconstruction surgery of the supraspinatus muscle lesions

Šmíd¹,

Komzák²,

Hart³

et al. 2017

Clinical-Investigation

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Background: The objective of the study was to demonstrate the effect of concentrated bone marrow stem cells (MSCs) to the healing of sutured tendon of the supraspinatus muscle in comparison to the same procedure performed without MSCs. We have postulated the hypothesis that MSCs enhance the healing of the sutured supraspinatus tendon to its humeral footprint. Methods and findings:None of the patients had to be excluded from our prospective randomized study. 50 patients met the indication criteria for isolated supraspinatus surgery. 25 patients (Group I) received MSCs into the supraspinatus footprint. 25 patients (Group II) was treated without the use of MSCs. Patients were examined pre-operatively, 6, 12 and 24 months after the surgery and assessment included physical examination, visual analogue scale (VAS), ASES (American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form) and Constant score. Patients underwent MRI 2 years postoperatively. Findings were compared with the preoperative results.We have found no statistically significant differences between both groups pre-operatively. After a 24-month follow-up period there were significant differences observed in all clinical outcomes. When compared results between both groups two years postoperatively, p-value (p=0.05) for the VAS score was 0.0176 and for the Constant score 0.0355. The only statistically non-significant was p-value for the ASES score comparing results from both groups at two years follow-up (p=0.085). The MRI findings at 2 years showed fully healed tissue of the rotator cuff tendon in 17 patients in the Group I, but only in 9 patients in the Group II. Conclusions:We have accepted the hypothesis that MSCs enhance the healing of the sutured supraspinatus tendon to its humeral footprint.

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Open repair of massive rotator cuff tears in patients aged sixty-five years or over: Is it worthwhile?

Cited by 83 publications

References 23 publications

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Functional Recovery Period after Arthroscopic Rotator Cuff Repair: Is it Predictable Before Surgery?

Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

Mesenchymal stem cells in the reconstruction surgery of the supraspinatus muscle lesions

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