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

Silva, Bruno Mota; Cartucho, António; Sarmento, Marco; Moura, Nuno

doi:10.20344/amp.8307

Cited by 8 publications

(4 citation statements)

References 40 publications

(86 reference statements)

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“…Silva et al 210 systematically reviewed 14 studies of patients aged ≥65 years who underwent arthroscopic, MO, or open surgical repair of a symptomatic RC tear, and all studies demonstrated significant improvement between pre- and postoperative outcomes, with an overall postoperative patient satisfaction rate >90% and a healing rate of 78%. Downie and Miller 43 reported improved outcomes after surgery among patients >60 years old.…”

Section: Resultsmentioning

confidence: 99%

A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff

Jancuska

Matthews

Miller

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:The number of systematic reviews and meta-analyses published on the rotator cuff (RC) has increased markedly.Purpose:To quantify the number of systematic reviews and meta-analyses published on the RC and to provide a qualitative summary of the literature.Study Design:Systematic review; Level of evidence, 4.Methods:A systematic search for all systematic reviews and meta-analyses pertaining to the RC published between January 2007 and September 2017 was performed with PubMed, MEDLINE, and the Cochrane Database of Systematic Reviews. Narrative reviews and non–English language articles were excluded.Results:A total of 1078 articles were found, of which 196 met the inclusion criteria. Included articles were summarized and divided into 15 topics: anatomy and function, histology and genetics, diagnosis, epidemiology, athletes, nonoperative versus operative treatment, surgical repair methods, concomitant conditions and surgical procedures, RC tears after total shoulder arthroplasty, biological augmentation, postoperative rehabilitation, outcomes and complications, patient-reported outcome measures, cost-effectiveness of RC repair, and quality of randomized controlled trials.Conclusion:A qualitative summary of the systematic reviews and meta-analyses published on the RC can provide surgeons with a single source of the most current literature.

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Section: Resultsmentioning

confidence: 99%

A Systematic Summary of Systematic Reviews on the Topic of the Rotator Cuff

Jancuska

Matthews

Miller

et al. 2018

Orthopaedic Journal of Sports Medicine

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“…Because of their prolonged life expectancy and improved medical treatment, many elderly patients can manage high functional demands in their daily life [32]. Arthroscopic repair of the rotator cuff allows elderly patients to obtain functional improvement similar to that of their younger peers [33,34].…”

Section: Discussionmentioning

confidence: 99%

Are there differences in arthroscopic and histological features between traumatic and degenerative rotator cuff tears in elderly patients? A prospective dual-center analysis

et al. 2022

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Background Discriminating traumatic rotator cuff tears (RCTs) from degenerative RCTs is sometimes difficult in elderly patients because the prevalence of asymptomatic RCTs increases with age. Little intraoperative information is available on the characteristics of traumatic and degenerative RCTs in elderly patients. The purpose of this study was to compare the arthroscopic findings and histological changes of the coracoacromial ligament (CAL) between traumatic and degenerative RCTs in elderly patients. Methods Forty-two shoulders of 42 patients aged ≥ 65 years underwent arthroscopic rotator cuff repair. Nineteen patients had traumatic full-thickness RCTs (Group T), and 23 had degenerative full-thickness RCTs (Group D). The quality of the rotator cuff tissue and the condition of the long head of the biceps were examined. The grade of CAL was evaluated both arthroscopically and histologically. The stiffness of the musculotendinous unit was calculated by measuring the force and displacement using a tensiometer. The arthroscopic and histological findings of the two groups were compared. Results Although the mean tendon displacement was comparable, the stiffness was different between Group T and Group D (0.56 ± 0.31 and 1.09 ± 0.67 N/mm, respectively; p < 0.001). Both arthroscopic and histological analysis of the CAL showed that the degenerative changes in the CAL were milder in Group T than in Group D (p < 0.001 and p < 0.001, respectively). There was a moderate positive correlation between the arthroscopic findings of CAL degeneration and the histopathological changes in this ligament (r = 0.47, p = 0.002). Conclusions Traumatic RCTs were characterized by preserved elasticity of the musculotendinous unit and milder CAL degeneration compared with degenerative RCTs even in elderly patients.

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“…Overall, despite the likely variable clinical practice for the management of rotator cuff tears, diversity in patient selection and surgical technique, the majority of rotator cuff repair and reconstruction yield good outcomes post-operatively with overall improved patient satisfaction. 23 Clearly the surgeon needs to draw on experience and evidence base to help decide what treatment is optimal for each individual patient presenting with a symptomatic rotator cuff tear. In the UK in general, the commonest primary surgical management for the rotator cuff tear remains subacromial decompression, and repair of the cuff by an either open or arthroscopic repair using single or double row anchors.…”

Section: Discussionmentioning

confidence: 99%