Arthroscopic treatment of rotator cuff tear in the over-60s: Repair is preferable to isolated acromioplasty-tenotomy in the short term

Abstract

Randomized prospective study, level II.

Comparison of Functional Gains After Arthroscopic Rotator Cuff Repair in Patients Over 70 Years of Age Versus Patients Under 50 Years of Age: A Prospective Multicenter Study

“…There have been other studies that have proposed, because of muscle atrophy, tear size, and poor healing rates, that rotator cuff tears in elderly patients be treated with acromioplasty and biceps tenotomy alone. However, in a randomized study, Dezaly et al 34 showed that there is a benefit of repair in intermediate-size rotator cuff tears over acromioplasty and biceps tenotomy in patients older than 60 years, which supports our study's findings.…”

“…Many studies have shown that there is a correlation between healing and the functional outcome after rotator cuff repair. 7,8,17,34 However, Lafosse et al 4 found only a trend without statistical significance between these parameters. Boughebri et al 32 examined patients with arthroscopically repaired small infraspinatus tears and showed that no correlation exists between tendon healing and patient satisfaction or shoulder function according to the Constant score, which is consistent with our results.…”

“…Dezaly et al 34 found a rerupture rate of 47.6% in patients older than 70 years. Our results are closer to those presented by Flurin et al 17 They showed that 1 year after arthroscopic rotator cuff repair, there is a healing rate of 89% in patients older than 70 years.…”

Early anchor displacement after arthroscopic rotator cuff repair

“…Benson et al [11] investigated 269 patients who underwent arthroscopic rotator cuff repair and found six cases of early anchor pullouts (2.4 %). Dezaly et al [22] Apart from the higher pullout rate reported by other authors, some similarities in the factors affecting anchor displacement can be found, for example, as in Benson's study, larger tears were associated with higher incidence of anchor displacement; all of the loose anchors were pulled out of the greater tuberosity, and none of the screws implanted into the lesser tuberosity proved to be loose. The stability, and hereby the outcome of the cuff repair depends on different factors, such as the sutures, the anchor, the bone and the cuff.…”

Review: Complications of Rotator Cuff Surgery

“…Rotator manşet cerrahisinde dikiş çapa-sı yerleşimi sonrası geri gelme değişik çalışmalarda %0,1 ile %3,1 arasında bildirilmiştir (50)(51)(52) . Osteoporoz, retrakte manşet yırtığı ve birden fazla güçlendirilmiş sütürün tek implanta yüklenmesi geri gelme riskini artıran faktörlerdir (50,53) .…”