2015 ISAKOS Biennial Congress ePoster #2436

Clinical Outcomes After Arthroscopic Rotator Cuff Repair in Patients Aged Over 65 Years Old

Yohei Harada, MD, PhD, Hiroshima City, Hiroshima JAPAN
Shin Yokoya, MD, PhD, Hiroshima, Hiroshima JAPAN
Yoshihiro Nakamura, MD, Aki-gun, Hiroshima JAPAN
Katsunori Shiraishi, MD、PhD, Matsuyama, Ehime-ken JAPAN
Yu Mochizuki, MD, Hiroshima JAPAN
Mitsuo Ochi, MD, PhD, Higashi, Hiroshima JAPAN
Hiroshima University, Hiroshima, JAPAN

FDA Status Not Applicable

Summary: ARCR for patients aged over 65 years old provided significant improvement in clinical outcomes and age didn’t affect postoperative clinical results. We think age itself is not a factor influencing the indication of ARCR.

Abstract:

Introduction

The indication of rotator cuff repair among elderly patients is controversial. The purpose of this study is to evaluate the clinical outcomes after arthroscopic rotator cuff repair (ARCR) in patients aged over 65 years old and to make a review of the indication of ARCR to the elderly patients.

Methods

33 patients with 34 shoulders who underwent ARCR at the age of over 65 were enrolled in this study. All operations were performed by single surgeon using suture-bridge technique. Range of shoulder motion (forward elevation, external rotation and internal rotation), shoulder strength (abduction and external rotation), Constant shoulder score, UCLA shoulder rating scale, and Japanese Orthopedics Association shoulder score (JOA score) were evaluated before and after surgery with a minimum of 2 years follow-up. All patients received MRI before and after surgery to evaluate preoperative fatty infiltration using Fuchs classification, preoperative supraspinatus muscle atrophy using occupation ratio, and tendon healing using Sugaya’s classification.

Results

The mean follow-up duration was 27 months (range 24 to 36 months). Range of forward flexion, external rotation and internal rotation improved 118°±37° to 148°±34° (P<.01), 46°±22° to 57°±16° (P<.01), L1±3 level to T10±2 level (P<.01) respectively. Muscle strength of shoulder abduction and external rotation improved 26.8N±15.6N to 45.6N±17.6N (P<.01) and 31.1N±15.4N to 45.2N±19.2N (P<.01) respectively. Constant shoulder score, UCLA shoulder rating scale, and JOA score improved 47.0±14.0 to 76.1±8.4 (P<.01), 14.2±5.3 to 32.8±4.0 (P<.01), 61.0±11.4 to 95.2±5.76 (P<.01) respectively. We observed 7 retears (21%) and the retear was correlated with intraoperative tear size (P<.01) but not correlated with age, preoperative fatty infiltration or muscle atrophy. Age was not correlated with postoperative range of motion, muscle strength and clinical scores.

Conclusion

ARCR for patients aged over 65 years old provided significant improvement in clinical outcomes and age didn’t affect postoperative clinical results. We think age itself is not a factor influencing the indication of ARCR.