Arthroscopic repair of large to massive rotator cuff tears in patients younger than 60 years |
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| Affiliation: | 1. Department of Orthopaedic Surgery, Seoul St. Mary''s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea;2. Department of Orthopedic Surgery, Ewha Womans University, College of Medicine, Seoul, South Korea;1. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Japan;2. Department of Orthopedic Surgery, School of Medicine, International University of Health and Welfare, Chiba, Japan;3. Department of Orthopedic Surgery, Keio University School of Medicine, Tokyo, Japan;4. Department of Orthopaedic Surgery, Niigata University Medical and Dental Hospital, Niigata, Japan;5. Department of Orthopaedic Surgery, The Jikei University School of Medicine, Tokyo, Japan;6. Department of Spinal Surgery, Rakuwakai Marutamachi Hospital, Kyoto, Japan;7. Medical Division, Kyocera Corporation, Kyoto, Japan;1. Department of Orthopedic Surgery, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyoku, Tokyo 113-8511, Japan;2. Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 565-0871, Japan;3. Department of Orthopedic Surgery, Shiga University of Medical Science, Tsukinowa-cho, Seta, Otsu, Shiga 520-2112, Japan;4. Department of Orthopedic Surgery, Faculty of Medicine, University of Tsukuba, 2-1-1 Amakubo, Tsukuba, Ibaraki 305-8576, Japan;5. Department of Orthopedic Surgery, Gunma University School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma 371-8513, Japan;6. Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3125, Japan;7. Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumaicho, Showa Ward, Nagoya, Aichi 466-8550, Japan;8. Department of Orthopedic Surgery, Osaka Rosai Hospital, Nagasonecho 1179-3, Sakaishi, Kitaku, Osaka 591-8025, Japan;9. Department of Surgery, International University of Health and Welfare Ichikawa Hospital, Konodai 6-1-14, Ichikawashi, Chiba 272-0827, Japan;10. Department of Orthopedic Surgery, Faculty of Medicine, University of Toyama, 2630 Sugitani, Toyama, Toyama 930-0114, Japan;11. Guideline Committee of Ossification of the Spinal Ligament, Japanese Orthopaedic Association, Japan;1. Istanbul University, Cerrahpasa Medical Faculty Department of Orthopaedics and Traumatology, Istanbul, Turkey;2. Istanbul Technical University, Faculty of Mechanical Engineering, Istanbul, Turkey;3. Istanbul Medipol University Department of Orthopaedics and Traumatology, Istanbul, Turkey;1. University of Arizona College of Medicine-Tucson, 1501 N. Campbell Ave., Tucson, AZ 85724, USA;2. University of Arizona College of Medicine-Tucson, Department of Orthopaedic Surgery, 1609 N. Warren Avenue Suite 110, Tucson, AZ 85719, USA;1. Atlanta VA Medical Center, Decatur, GA;2. Division of Endocrinology and Metabolism and Lipids, Department of Medicine, Emory University School of Medicine, Atlanta, GA;3. Aflac Cancer and Blood Disorders Center of Children''s Healthcare of Atlanta, Department of Pediatrics, Emory University, Atlanta, GA;4. Department of Cellular Biology and Anatomy, Augusta University, Augusta, GA;5. Department of Orthopaedic Surgery, Medical College of Georgia, Augusta University, Augusta, GA;6. Department of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, GA |
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| Abstract: | BackgroundThe incidence of rotator cuff tears in young patients has increased recently with the increase in sports and recreation activities, however, few studies have reported clinical outcomes after arthroscopic repair of large to massive rotator cuff tears in young patients. This study aimed to evaluate preoperative characteristics and postoperative outcomes after arthroscopic repair of large to massive rotator cuff tears in patients younger than 60 years, and to compare these results with those of tear size-matched patients older than 60 years.MethodsForty-eight patients who underwent arthroscopic repair for large to massive rotator cuff tears were included. Group I (n = 24) consisted of patients younger than 60 years, while tear size-matched patients older than 60 years were assigned to group II (n = 24). Clinical outcomes were evaluated preoperatively and at 3, 6, and 12 months postoperatively, and at the final visit. All patients underwent magnetic resonance imaging (MRI) preoperatively and at 3 and 12 months postoperatively to evaluate repair integrity.ResultsThe mean patient age was 53.4 ± 4.2 years in group I and 67.4 ± 4.5 in group II (P = 0.001). At the last visit, there were no significant differences in postoperative clinical scores or passive range of motion between two groups. However, young patients complained of shoulder pain less frequently than elderly patients (visual analog scale for pain at last visit: 0.8 ± 0.3 in group I, 2.4 ± 1.9 in group II, P = 0.04). Elderly patients showed more advanced fatty infiltration preoperatively than young patients and advanced fatty infiltration was correlated with postoperative repair integrity (r = 0.83, P = 0.001). Postoperative re-tear rate was 12.5% in group I, and 33.3% in group II (P = 0.08).ConclusionMore satisfactory clinical and structural outcomes followed by less advanced preoperative fatty infiltration can be expected in younger patients compared with patients older than 60 years, based on large to massive rotator cuff tear treatment outcomes. |
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