2015 ISAKOS Biennial Congress ePoster #2433
Clinical Outcomes of Arthroscopic Rotator Cuff Repair in Patients Younger Than 30 Years of Age: Average 4-Year Follow-Up
Rachel M. Frank, MD, Aurora, CO UNITED STATES
Christopher R. Mellano, MD, Torrance, CA UNITED STATES
Petar Golijanin, Research Coordinator, Boston, MA UNITED STATES
Brett Monson, BS, Chicago, IL UNITED STATES
Gregory P. Nicholson, MD, Chicago, IL UNITED STATES
Brian J. Cole, MD, MBA, Chicago, IL UNITED STATES
Nikhil N. Verma, MD, Chicago, IL UNITED STATES
Anthony A. Romeo, MD, Scarsdale, NY UNITED STATES
Matthew T. Provencher, MD, Vail, CO UNITED STATES
Rush University Medical Center, Chicago, IL, USA
FDA Status Not Applicable
Summary: Patients undergoing arthroscopic RCR under the age of 30 demonstrate acceptable clinical outcomes at medium-term follow-up, with significant improves in ASES scores.
Arthroscopic rotator cuff repair (RCR) is effective at reducing pain and improving function in the majority of patients with rotator cuff pathology. With the average age of patients undergoing RCR approaching 55 however, the outcomes of arthroscopic RCR in younger patients are less predictable. Younger patients often function at higher activity levels than the typical patient undergoing RCR, and may place substantial demands on the repair. The purpose of this study was to analyze the clinical outcomes of patients undergoing arthroscopic RCR in patients younger than 30 years old.
All patients undergoing arthroscopic rotator cuff repair under the age of 30 at the time of surgery were retrospectively reviewed. Patients undergoing revision arthroscopy or those with less than two years of clinical follow-up were excluded. Clinical follow-up was performed with physical examination and clinical outcomes scores including Single Assessment Numeric Evaluation, American Shoulder and Elbow Surgeons (ASES), and Western Ontario Rotator Cuff (WORC) scores. Descriptive statistics were performed as well as Student’s T-Test for comparison of pre-operative and post-operative outcomes scores, with significance determined for P values less than 0.05. Complications and revisions surgeries were analyzed and reported, with failures noted as any patient with recalcitrant ipsilateral atraumatic shoulder pain or revision RCR surgery.
Eleven patients met the study criteria with a mean age of 24.6±4.4 years (range, 17.6 to 30.0 years) at the time of surgery at an average 4.2±2.8 years (range, 2.0 to 9.8 years) of clinical follow-up. Average ASES scores improved from 47.8±7.3 pre-operatively to 80.4±12.8 at final follow-up (P<0.001). Average post-operative SANE scores were 79.3±17.2. Average WORC scores were 385.2±176.5. Two patients (18.2%) including one high level gymnast and one high level volleyball player had persistent pain with overhead activities and were considered failures. While neither patient required revision RCR, both patients underwent subsequent arthroscopy at 1.9 years (glenohumeral debridement, subacromial decompression, mini-open biceps tenodesis) and 1.1 years (posterior-inferior capsular release, subacromial decompression) following the index procedure.
Patients undergoing arthroscopic RCR under the age of 30 demonstrate acceptable clinical outcomes at medium-term follow-up, with significant improves in ASES scores. However, 18.2% of patients failed without a specific traumatic etiology, with injury mechanisms more often related to repetitive overuse, and caution must be exerted in this young, highly-active patient population. Certainly, larger studies with a longer duration of follow-up must be performed to better understand these results.