Traitement chirurgical des lésions de la coiffe des rotateurs du sujet de moins de 50 ans

Abstract

BackgroundRotator cuff tears are classically considered to result from a degenerative process. Many studies have reported satisfactory outcome for surgical treatment in older patients. Information is scarce however on partial or total cuff repairs, using arthroscopic or open procedures, in younger populations. The purpose of this work was to analyze the literature on rotator cuff repair in patients aged less than 50 years. MethodsA bibliography search of Pubmed and Google scholar was conducted using the keywords “rotator cuff tears”, “rotator cuff repairs”, and “younger patients”. The last search was performed on April 15, 2014. Inclusion criteria were studies written in English or French, concerning chronic or acute cuff tears in patients aged less than 50 years, level of proof 1–4, and clinical results in at least 10 patients. Exclusion criteria were reviews of the literature, expert opinions, early studies published more than 15 years ago and non-clinical studies. The main endpoint was clinical outcome of rotator cuff repair in young subjects aged less than 50 years. ResultsTen studies published between 1999 and 2013 were retained. Together, these studies provided outcomes for 306 operated patients. Mean follow-up was 48 months (range 18–71). A good subjective outcome is reported in more than 85.3% of patients (range 55–97) who were satisfied or very satisfied. Patients were able to resume their occupational or sports activities in 91% of cases, within a mean delay of 4.8 months. ConclusionRotator cuff tears in young subjects are most often trauma or sports related. Male gender predominates. Functional outcome of surgical treatment of these lesions has been good.