Open rotator cuff repairs in patients 70 years and older

Carvalho, Bruno Roque De; Puri, Arvind; Calder, J.

doi:10.1111/j.1445-2197.2012.06034.x

Cited by 10 publications

(26 citation statements)

References 31 publications

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“…Amid all confusion and controversies, there are surgeons who recommended repair for all symptomatic individuals, regardless of age [6] . However, there is a genuine paucity of literature recommending rotator cuff repair in patients aged 70 years and older [17,18] and only a few studies have published all arthroscopic rotator cuff repair (ARCR) in this particular age group [15,19] .…”

Section: Clinical Outcome Of Arthroscopic Rotator Cuff Repair In Patimentioning

confidence: 99%

Clinical Outcome of Arthroscopic Rotator Cuff Repair in Patients Aged 70 Years and Older

Babhulkar¹,

Ravikumar²,

Patil³

et al. 2019

International Journal of Orthopaedics

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AIM: The purpose of this study was to evaluate the outcome of arthroscopic rotator cuff repair in patients aged 70 years or older and report our results in terms of pain, range of motion, muscle strength, and functional outcome. MATERIALS AND METHODS: We performed retrospective data review and identified 97 shoulders (94 patients) of our interest with minimum 24 months of follow-up. All patients were evaluated with Visual Analogue Scale (VAS), Range of motion (ROM), Manual Muscle Strength, and Oxford Shoulder Score (OSS) preoperatively and at final follow-up. Patient satisfaction was determined by asking patients whether they were satisfied (yes or no). Statistical analysis was performed using paired t test to compare pre and postoperative measures and Mann-Whitney U test to see the effect of age and gender on the final outcome. RESULTS: Of 97 shoulders, 70 (67.9%) shoulders were available for final evaluation with a mean age of 73.56 years (70 to 81) and mean follow-up of 57.52 months (24 to 122). Mean VAS for pain was improved from 8.4 (6 to 10) to 1.04 (0 to 5) (p < 0.001) at final follow-up. Mean forward flexion, abduction, external rotation increased from 112.50º to 165.43º (p < 0.001), 114.36º to 166.86º (p < 0.001), 45.14º to 73.64º (p < 0.001) respectively, as well as, Internal rotation also improved in 55 patients (78.5%, n = 70) at final followup. Mean muscle strength of Supraspinatus (SSP) and Infraspinatus (ISP) according to MRC scale was significantly improved (p < 0.05) from 2.84 (2 to 4) to 4.67 (4 to 5) and from 2.77 (2 to 4) to 4.64 (3 to 5) at the final follow-up respectively. Mean OSS was improved from 11.49 to 44.40 (p < 0.001) and only three patients (4.28%, n = 70) were subjectively less than satisfied at final follow-up. CONCLUSIONS: There was a significant improvement in shoulder function with a low complication rate. Hence, we have no hesitation to recommend repair in this age group. Provided the rotator cuff is not grossly wasted, and patient is fit to undergo surgery, age should not be the criteria for determining repairability.

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Section: Clinical Outcome Of Arthroscopic Rotator Cuff Repair In Patimentioning

confidence: 99%

Clinical Outcome of Arthroscopic Rotator Cuff Repair in Patients Aged 70 Years and Older

Babhulkar¹,

Ravikumar²,

Patil³

et al. 2019

International Journal of Orthopaedics

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“…Currently, over 300,000 surgeries are performed annually in the United States to repair rotator cuff tears [3], and this number is likely to rise with the projected increase in elderly populations [4]. Re-tear rates are high, especially with increasing tear size [5,6], and massive rotator cuff tears may not be amenable to traditional suture repair [7].…”

Section: Introductionmentioning

confidence: 99%

Aligned multilayered electrospun scaffolds for rotator cuff tendon tissue engineering

et al. 2015

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The rotator cuff consists of several tendons and muscles that provide stability and force transmission in the shoulder joint. Whereas most rotator cuff tears are amenable to suture repair, the overall success rate of repair is low, and massive tears are prone to re-tear. Extracellular matrix (ECM) patches are used to augment suture repair, but they have limitations. Tissue-engineered approaches provide a promising solution for massive rotator cuff tears. Previous studies have shown that, compared to nonaligned scaffolds, aligned electrospun polymer scaffolds exhibit greater anisotropy and exert a greater tenogenic effect. Nevertheless, achieving rapid cell infiltration through the full thickness of the scaffold is challenging, and scaling to a translationally relevant size may be difficult. Our goal was to evaluate whether a novel method of alignment, combining a multilayered electrospinning technique with a hybrid of several electrospinning alignment techniques, would permit cell infiltration and collagen deposition through the thickness of poly(ε-caprolactone) scaffolds following seeding with human adipose-derived stem cells. Furthermore, we evaluated whether multilayered aligned scaffolds enhanced collagen alignment, tendon-related gene expression, and mechanical properties compared to multilayered nonaligned scaffolds. Both aligned and nonaligned multilayered scaffolds demonstrated cell infiltration and ECM deposition through the full thickness of the scaffold after only 28 days of culture. Aligned scaffolds displayed significantly increased expression of tenomodulin compared to nonaligned scaffolds and exhibited aligned collagen fibrils throughout the full thickness, the presence of which may account for the increased yield stress and Young’s modulus of cell-seeded aligned scaffolds along the axis of fiber alignment.

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“…Many studies have been recently published on rotator cuff repair in patients over 60 and 70 years of age. De Carvalho et al 45 reviewed 104 cases of openly repaired RCTs in a group of patients with a mean age of 77 years and reported a high satisfaction rate of 92.7%, as well as pain relief and high-level function. However, a recent systematic review concluded that, although there could be a benefit of a surgical approach, the heterogeneity of the treatments does not allow generalization.…”

Section: Degenerative Pathologymentioning

confidence: 99%

Shoulder surgery in older patients: recommendations and techniques

Valencia

Calvo

2013

Rev. Clin. Gerontol.

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SummaryShoulder disorders are very common in the older population. These can be traumatic injuries such as proximal humerus fractures, or degenerative pathology, with rotator cuff disease being the most frequently diagnosed. Lower functional demands along with the presence of co-morbidities means that conservative management is usual. However, surgery can provide pain relief and improve functional outcomes in selected patients. A thorough pre-operative assessment should be performed to avoid surgical or post-operative complications. Osteoporosis is the major concern when undertaking bone fixation in orthopaedic implants and should be routinely ruled out and treated in order to achieve better results.

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Open rotator cuff repairs in patients 70 years and older

Abstract: Level IV (observational study without control - retrospective study).

Cited by 10 publications

References 31 publications

Clinical Outcome of Arthroscopic Rotator Cuff Repair in Patients Aged 70 Years and Older

Clinical Outcome of Arthroscopic Rotator Cuff Repair in Patients Aged 70 Years and Older

Aligned multilayered electrospun scaffolds for rotator cuff tendon tissue engineering

Shoulder surgery in older patients: recommendations and techniques

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