Effect of Age on Functional and Structural Outcome after Rotator Cuff Repair

Oh, Joo Han; Kim, Sae Hoon; Kang, Jung Mook; Oh, Chung Hee; Gong, Hyun Sik

doi:10.1177/0363546509352460

Cited by 137 publications

(57 citation statements)

References 46 publications

(77 reference statements)

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“…Chung et al [15] , in another study of 108 patients who underwent arthroscopic repair of massive rotator cuff tears, found that while several factors were associated with failure of cuff healing in the univariate analysis including age, only fatty infiltration was significantly related to healing failure in the multivariate analysis. Similarly, Oh et al [13] noted that age was not an independent predictor of tendon healing or functional outcome. Tear retraction and fatty atrophy were found to be the only independent predictors of tendon healing in their study [13] .…”

Section: Agementioning

confidence: 96%

“…Similarly, Oh et al [13] noted that age was not an independent predictor of tendon healing or functional outcome. Tear retraction and fatty atrophy were found to be the only independent predictors of tendon healing in their study [13] . Therefore, age may be a surrogate for other anatomical factors correlated with impaired healing after rotator cuff repair.…”

Section: Agementioning

confidence: 96%

“…The average age of patients with unhealed repairs in their series was 60.1 compared to 53.8 in the healed group. Finally, Oh et al [13] , in a study of 177 patients after arthroscopic and mini-open rotator cuff repairs of various techniques, also noted that increasing age was associated with lower rates of tendon healing. The average age of patients with unhealed repairs in their series was 63.7 compared to 58.4 in the healed group [13] .…”

Section: Agementioning

confidence: 97%

“…Finally, Oh et al [13] , in a study of 177 patients after arthroscopic and mini-open rotator cuff repairs of various techniques, also noted that increasing age was associated with lower rates of tendon healing. The average age of patients with unhealed repairs in their series was 63.7 compared to 58.4 in the healed group [13] . The detrimental effect of increasing age on tendon healing after rotator cuff repair may be due to other factors affecting tendon healing rather than to age itself.…”

Section: Agementioning

confidence: 97%

“…Increasing patient age has been associated with lower rates of tendon healing after rotator cuff repair in multiple studies [5,[11][12][13] . The detrimental effect of age on rotator cuff tendon healing appears to be independent of the surgical technique utilized for repair.…”

Section: Agementioning

confidence: 99%

See 4 more Smart Citations

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

162

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Rotator cuff repair has been shown to have good longterm results. Unfortunately, a significant proportion of repairs still fail to heal. Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscle-tendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing. Surgeon related factors that can influence healing include repair construct-single vs double row, rehabilitation, and biologics including platelet rich plasma and mesenchymal stem cells. Double-row repairs are biomechanically stronger and have better healing rates compared with single-row repairs although clinical outcomes are equivalent between both constructs. Slower, less aggressive rehabilitation programs have demonstrated improved healing with no negative effect on final range of motion and are therefore recommended after repair of most full thickness tears. Additionally no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates and clinical outcomes. Further research is needed to identify effective biologically directed augmentations that will improve healing rates and clinical outcomes after rotator cuff repair. Core tip: Many factors, both patient and surgeon related, can influence healing after repair. Older age, larger tear size, worse muscle quality, greater muscletendon unit retraction, smoking, osteoporosis, diabetes and hypercholesterolemia have all shown to negatively influence tendon healing after rotator cuff repair. Smoking cessation and blood glucose and cholesterol control are methods to potentially improve healing rates. Slower, less aggressive rehabilitation programs may improve healing rates with no negative effect on final range of motion and are therefore recommended after arthroscopic repair of most full thickness tears. Finally, no definitive evidence supports the use of platelet rich plasma or mesenchymal stem cells regarding improvement of healing rates after rotator cuff repair. Routine use of these adjuvants is therefore not currently recommended.

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Section: Agementioning

confidence: 96%

Section: Agementioning

confidence: 96%

Section: Agementioning

confidence: 97%

Section: Agementioning

confidence: 97%

Section: Agementioning

confidence: 99%

See 3 more Smart Citations

Factors affecting healing after arthroscopic rotator cuff repair

Abtahi

Granger

Tashjian

2015

WJO

162

View full text Add to dashboard Cite

show abstract

Rotator Cuff Tears

Blanco

Garcia-Portabella²,

Batalla³

et al. 2021

Evidence‐Based Orthopedics

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Cell lineage tracing and functional assessment of supraspinatus tendon healing in an acute repair murine model

Moser

Abraham

Howell

et al. 2020

Journal Orthopaedic Research

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Rotator cuff supraspinatus tendon injuries are common with high rates of anatomic failure after surgical repair. The purpose of the study was to define clinically relevant features of a mouse model of supraspinatus tendon injury to determine painful, functional, and structural outcomes; we further investigated two cell populations mediating healing using genetic lineage tracing after full detachment and repair of the supraspinatus tendon in mice. The pain was assessed using the mouse grimace scale and function by gait analysis and tensile testing. Histological and microCT analyses were used to determine enthesis/tendon and bone structure, respectively. Lineage tracing was carried out using inducible Cre lines for ScxCreERT2 (tendon cells) and αSMACreERT2 (myofibroblasts and mesenchymal progenitors). Mice only expressed pain transiently after surgery despite long‐term impairment of functional and structural properties. Gait, tensile mechanical properties, and bone properties were significantly reduced after injury and repair. Lineage tracing showed relatively few Scx lin tendon cells while αSMA lin cells contributed strongly to scar formation. Despite surgical reattachment of healthy tendon, lineage tracing revealed poor preservation of supraspinatus tendon after acute injury and loss of tendon structure, suggesting that tendon degeneration is also a key impediment of successful rotator cuff repair. Scar formation after surgery is mediated largely by αSMA lin cells and results in permanently reduced functional and structural properties.

show abstract

Effect of Age on Functional and Structural Outcome after Rotator Cuff Repair

Cited by 137 publications

References 46 publications

Factors affecting healing after arthroscopic rotator cuff repair

Factors affecting healing after arthroscopic rotator cuff repair

Rotator Cuff Tears

Cell lineage tracing and functional assessment of supraspinatus tendon healing in an acute repair murine model

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