Do elderly patients gain as much benefit from arthroscopic rotator cuff repair as their younger peers?

Witney-Lagen, Caroline; Mazis, G.; Bruguera, Juan; Atoun, Ehud; Sforza, Giuseppe; Levy, Ofer

doi:10.1016/j.jse.2018.10.010

Cited by 19 publications

(24 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Included in the meta-analysis of postoperative Constant-Murley scores were 7 studies 1 , 6 , 9 , 10 , 13 , 20 , 21 with a total of 482 male and 354 female patients. The mean postoperative Constant-Murley score was 76.77 ± 15.94 for male patients and 69.88 ± 17.02 for female patients.…”

Section: Resultsmentioning

confidence: 99%

Comparing Sex-Specific Outcomes After Rotator Cuff Repair: A Meta-analysis

Fancher

Mok

Vopat

et al. 2022

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: Rotator cuff repair (RCR) is a well-studied procedure. However, the impact of patient sex on outcomes after RCR has not been well studied. Purpose: To conduct a systematic review and meta-analysis of sex-based differences in outcomes after RCR and to record what proportion of studies examined this as a primary or secondary purpose. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review was performed using multiple databases according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included if they were written in English, performed on humans, consisted of patients who underwent RCR, evaluated at least 1 of the selected outcomes based on patient sex, and had statistical analysis available for their sex-based claim. Excluded were case reports, review studies, systematic reviews, cadaveric studies, and studies that did not report at least 1 sex-specific outcome or included certain other injuries associated with a rotator cuff injury. Results: Of 9998 studies screened and 1283 full-text studies reviewed, 11 (0.11%) studies with 2860 patients (1549 male and 1329 female) were included for quantitative analysis. None of these 11 studies examined the impact of patient sex on outcomes after RCR as a primary outcome. Postoperative Constant-Murley scores were analyzed for 7 studies. Male patients had a postoperative Constant-Murley score of 76.77 ± 15.94, while female patients had a postoperative Constant-Murley score of 69.88 ± 17.02. The random-effects model showed that male patients had significantly higher scores than female patients, with a mean difference of 7.33 (95% CI, 5.21-9.46; P < .0001). Analysis of retear rates in 5 studies indicated that there was no difference in the retear rate between sexes (odds ratio, 0.91 [95% CI, 0.49-1.67]). Conclusion: Female patients had lower postoperative Constant-Murley scores compared with male patients, but there was no difference in the retear rate. However, these results were based on an analysis of only 11 studies. The paucity of studies examining the impact of sex suggests that more research is needed on the impact of patient sex on outcomes after RCR.

show abstract

Section: Resultsmentioning

confidence: 99%

Comparing Sex-Specific Outcomes After Rotator Cuff Repair: A Meta-analysis

Fancher

Mok

Vopat

et al. 2022

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

show abstract

“…found that postoperative complication rates did not differ between patient cohorts older or younger than 75. 17 Our study found that while patients over 65 years old were at increased risk for short-term complications following arthroscopic rotator cuff repair relative to younger patients, the risk of age as an independent risk factor may be overstated per our findings after matching. After matching, the only differences in short-term complications were that older patients had a slightly higher incidence of unplanned readmission and overall medical complications within 30 days of surgery.…”

Section: Discussionmentioning

confidence: 49%

“…Previous studies 10 , 17 have provided contrasting conclusions regarding the incidence and significance of short-term complications following rotator cuff repair in elderly patients. Padaki et al.…”

Section: Discussionmentioning

confidence: 99%

Increased 30-Day Postoperative Readmission and Medical Complication Rates Among Patients 65 Years and Older Following Arthroscopic Rotator Cuff Repair

Plantz

Gerlach

et al. 2022

Arthroscopy, Sports Medicine, and Rehabilitation

View full text Add to dashboard Cite

“…Recent studies have shown that patients >75 years have excellent postoperative outcomes after arthroscopic rotator cuff repairs, comparable with their younger counterparts. 26,42 Frailty, as measured using the MFI, was a much stronger predictor of functional outcomes after rotator cuff repair. Given this, the MFI appears to be a better risk stratification tool than is chronologic age.…”

Section: Discussionmentioning

confidence: 96%

Comparing the Predictors of Functional Outcomes After Arthroscopic Rotator Cuff Repair Modified Frailty Index, Clinical Frailty Scale, and Charlson Comorbidity Index

Moorthy

Lee

Ang

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The incidence of rotator cuff tears increases with age, and operative management is usually required in patients with persistent symptoms. Although several studies have analyzed the effect of age and comorbidities on outcomes after rotator cuff repair, no study has specifically examined the consequence of frailty. Purpose: To determine the best frailty/comorbidity index for predicting functional outcomes after arthroscopic rotator cuff repair. Study Design: Cohort study; Level of evidence, 3. Methods: The authors conducted a retrospective cohort study of 340 consecutive patients who underwent unilateral arthroscopic rotator cuff repair at a tertiary hospital between April 2016 and April 2018. All patients had undergone arthroscopic double-row rotator cuff repair with subacromial decompression by a single fellowship-trained shoulder surgeon. Patient frailty was measured using the Modified Frailty Index (MFI), Clinical Frailty Scale (CFS), and Charlson Comorbidity Index (CCI), calculated through retrospective chart review based on case notes made just before surgery; patient age and sex were also noted preoperatively. Functional outcomes using the Oxford Shoulder Score (OSS), Constant Shoulder Score (CSS), University of California Los Angeles (UCLA) Shoulder Score, and visual analog scale for pain were measured preoperatively and at 3, 6, 12, and 24 months postoperatively. Results: The MFI was a consistent significant predictor in all functional outcome scores up to 24 months postoperatively ( P < .05), unlike the CFS and CCI. Sex was also a significant predictor of postoperative OSS, CSS, and UCLA Shoulder Score, with male sex being associated with better functional outcomes. Patients with higher MFI scores had slower functional improvement postoperatively, but they eventually attained functional outcome scores comparable with those of their counterparts with lower MFI scores at 24 months postoperatively. Conclusion: The MFI was found to be a better tool for predicting postoperative function than was the CFS or CCI in patients undergoing arthroscopic rotator cuff repair. The study findings suggest that a multidimensional assessment of frailty (including both functional status and comorbidities) is important in determining functional outcomes after arthroscopic rotator cuff repair.

show abstract

Do elderly patients gain as much benefit from arthroscopic rotator cuff repair as their younger peers?

Cited by 19 publications

References 50 publications

Comparing Sex-Specific Outcomes After Rotator Cuff Repair: A Meta-analysis

Comparing Sex-Specific Outcomes After Rotator Cuff Repair: A Meta-analysis

Increased 30-Day Postoperative Readmission and Medical Complication Rates Among Patients 65 Years and Older Following Arthroscopic Rotator Cuff Repair

Comparing the Predictors of Functional Outcomes After Arthroscopic Rotator Cuff Repair Modified Frailty Index, Clinical Frailty Scale, and Charlson Comorbidity Index

Contact Info

Product

Resources

About