Arthroscopic Repair of Traumatic Rotator Cuff Tears in Patients 70 Years and Older

Abstract

There continues to be significant debate on how to manage traumatic rotator cuff tears in older patients. To evaluate the clinical outcomes of patients ≥70 years who underwent arthroscopic repair of traumatic rotator cuff tears. Case series; Level of evidence, 4. This retrospective review of prospectively collected data examined outcomes after arthroscopic rotator cuff repair in patients aged ≥70 years with traumatic full-thickness rotator cuff tears. The authors compared preoperative and postoperative outcomes, including American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, pain visual analog scale (pVAS) scores, and range of motion measures, as well as assessing postoperative complications. A total of 31 patients met the inclusion criteria. The mean patient age at the time of surgery was 73.6 ± 3.3 years (range, 70-82 years), and the mean follow-up was 38.8 months (range, 24-99 months). The most common mechanism of injury was low-energy falls (87%), followed by motor vehicle collisions (13%). From preoperatively to postoperatively, ASES scores improved from 36.5 ± 15.5 to 95.2 ± 7.7, SANE scores improved from 41.13% ± 20.4% to 94% ± 10.26%, and pVAS scores improved from 7.74 ± 2.13 to 0.48 ± 1.03 (P < .0001 for all). A comparison of repairs performed at <6 months versus ≥6 months from injury yielded no statistically significant differences in ASES, SANE, or pVAS scores (P = .930, .445, and .806, respectively) or in forward flexion, external rotation, or internal rotation (P = .328, .063, and .811, respectively) at the final follow-up. Arthroscopic rotator cuff repair for traumatic full-thickness tears in patients aged ≥70 years demonstrated favorable clinical results. Surgery before or after 6 months of injury did not affect outcomes in this cohort. Surgical treatment should be strongly considered for traumatic rotator cuff tears in the elderly population.