2019 ISAKOS Biennial Congress Paper #58
Do Elderly Patients Gain as Much Benefit from Arthroscopic Rotator Cuff Repair as Their Younger Counterparts?
Caroline Witney-Lagen, MD, Reading, Berkshire UNITED KINGDOM
George Mazis, Reading, Berkshire UNITED KINGDOM
Andreas Leonidou, MD, Reading, Berkshire UNITED KINGDOM
Georgios Panagopoulos, MD, London UNITED KINGDOM
Juan Bruguera, MD, Pamplona SPAIN
Ehud Atoun, MD, Karakur ISRAEL
Giuseppe Sforza, Pratica Di Mare, Rome ITALY
Ofer Levy, MD, MCh(Orth), FRCS, Reading, Berkshire UNITED KINGDOM
Reading Shoulder Unit, Reading, Berkshire, UNITED KINGDOM
FDA Status Not Applicable
Summary
To ascertain whether patients aged over 75 years achieve outcomes comparable to younger patients following arthroscopic rotator cuff repair.
Abstract
Purpose
To ascertain whether patients aged over 75 years achieve outcomes comparable to younger patients following arthroscopic rotator cuff repair.
Methods
The study comprised 60 shoulders in 59 patients aged over 75 who underwent arthroscopic cuff repair. For comparison, a control group of 60 younger patients matched for sex, tear size and ASA grade were included. Surgery was performed between 2006 and 2016. Outcomes collected prospectively were Constant score (CS), pain and satisfaction. Retrospective data collected included operative complications and demographics. Mean follow-up was 29 months.
Results
Mean age in the elderly group was 78 years compared to 59 years in the younger group. Tear sizes were 25 massive, 20 large, 12 medium and 3 small. Elderly patients CS improved by 25.1 points compared to 23.7 points for younger patients (p=0.742). Pain improved by 7.5/15 in elderly patients versus 6.2/15 in younger patients (p=0.055). 55/60 older patients were satisfied with surgery compared to 52/60 younger patients (p=0.378). Overall complication rate did not differ between the groups (p=0.509). One patient in each group developed an infection and a stiff shoulder. One younger patient developed an ACJ cyst and one suffered a traumatic re-tear. Four elderly patients had subsequent rTSA at a mean of 28 months after cuff repair. Massive tears had higher risk for subsequent rTSA (p=0.026).
Conclusion
Elderly patients benefit from arthroscopic rotator cuff repair as much as their younger counterparts. Similar improvements in CS, pain and satisfaction occurred for both elderly and younger patients. Arthroscopic repair was a safe and effective solution for treating symptomatic cuff tears in both age groups. Even elderly patients with massive tears showed clinically significant improvements following repair. Arthroscopic rotator cuff repair should be considered as a valuable treatment irrespective of age.