Clinical and Structural Outcomes of Arthroscopic Rotator Cuff Repair in Patients Over 75 Years Are Comparable to Those in Younger Patients: A Propensity Score-Matched Comparative Study

Abstract

PurposeTo compare clinical and structural outcomes of arthroscopic rotator cuff repair (ARCR) in patients over 75 years and those under 75 years and to analyze the factors associated with retear and clinical outcomes after ARCR. MethodsThis retrospective study reviewed patients who underwent ARCR between 2011 and 2021 with at least 2-years of follow-up. Using propensity score matching for sex, tear size, subscapularis involvement, and follow-up time, this study included 54 patients older than 75 years (group A) and 54 patients younger than 75 years (group B). Cuff integrity was evaluated using magnetic resonance imaging (MRI). Structural and clinical outcomes were compared between the two groups. ResultsThe mean improvements in external rotation (P = .030) and the ASES score (P = .043) were significantly higher in group A. Visual analog scales for pain and function, American Shoulder and Elbow Surgeons (ASES) score, and Constant score were significantly improved in both groups (all P = .001). On routine postoperative MRI at 6 months, the retear rate was 20.4% (11/54) in group A and 18.5% (10/54) in group B with no statistical difference between the two groups (P = .808). Factor analysis in group A showed that follow-up duration (P = .019), tear size in mediolateral dimension (P = .037), occupation ratio (P = .036), and incomplete repair (P = .034) were associated with retear, and mild glenohumeral arthritis (P = .003) and subscapularis involvement (P = .018) were associated with inferior Constant score. ConclusionClinical and structural outcomes after ARCR in patients aged 75 years or older are comparable to those in patients younger than 75 years. Level of evidenceIII, Retrospective case-control study