Rotator cuff repair in patients fifty years of age and younger.

Abstract

Currently, there is no information on the long-term results of rotator cuff repair in young patients. The purpose of the present study was to determine the results, the risk factors for an unsatisfactory outcome, and the rates of failure of this procedure in patients fifty years of age and younger. Thirty-two patients (thirty-six shoulders) who were fifty years of age or younger underwent repair of a full-thickness rotator cuff tear between 1976 and 1987. Seven patients (seven shoulders) died after less than thirteen years of follow-up. The remaining twenty-nine shoulders, which had been followed for a minimum of thirteen years or until revision surgery, were included in the analysis. The most recent follow-up was performed in the clinic for five shoulders and by means of a questionnaire for twenty-four shoulders. There were three small, fifteen medium, six large, and five massive tears. Rotator cuff repair was associated with significant long-term pain relief (p = 0.0001). However, there was no significant long-term improvement in active abduction or external rotation. Postoperative pain, active abduction, and external rotation did not vary significantly according to gender, tear size, repair type, or whether a distal clavicular excision had been performed. There were eleven excellent, five satisfactory, and thirteen unsatisfactory results. Seven shoulders had additional surgery for the treatment of a recurrent tear (five), instability (one), or osteoarthritis (one). Three of the five repairs that were done for the treatment of a recurrent tear were performed ten years or more after the time of the index procedure. Rotator cuff repair in young patients is associated with long-term pain relief. However, this procedure is not associated with significant long-term improvement in motion, and a large proportion of patients have an unsatisfactory long-term result. The results of rotator cuff repair in young patients appear to be less favorable than those in a mixed-age population.