Arthroscopic Rotator Cuff Repair in the Elderly: Long-Term Outcomes

Abstract

Abstract Introduction: Rotator cuff tear (RCT) is one of the most common ailments around the shoulder. Its incidence increases significantly with age. However, owing to the variable healing potential and retear rates, the ideal management of RCT in the elderly is still up for debate. The purpose of this study is to observe and analyze the long-term functional outcomes in patients older than 60 years of age, who have undergone arthroscopic RCT repair. Methods: Fifty-seven cases who had undergone arthroscopic RCT repair with a minimum postoperative follow-up for 3 years were identified, in this single surgeon monocentric retrospective study. They were assessed using shoulder pain and disability index (SPADI) scoring. Results: Out of the 57 patients with ages more than 60 years, 10 were beyond 70 years of age. The mean age of the group was 65.2 years (standard deviation [SD] =4.86) ranging from 60 to 84 years. The mechanism of injury was atraumatic in 27 cases. The mean follow-up period was 57.9 months (SD = 15.7). The cases were categorized based on the number of rotator cuff tendons involved in the tear. The mean SPADI% for pain in all the cases was 0.98% (SD = 2.1). Forty-two out of the total 57 cases had a SPADI of 0%. They were completely asymptomatic, with their operated shoulder as good as the other. No statistically significant correlation was found between the SPADI scores and the number of tendons repaired (r = 0.06). Conclusion: An optimal tension-free arthroscopic repair of the RCT can yield good results even in the elderly. The age of the patient, the duration of the tear before surgery, and the size of the tear should not be considered as a stand-alone factor to deny surgical management if the fatty infiltration is within a limit. Irrespective of the retear rates the overall functional outcomes are still good.