Chiara Fossati1,2, Carlo Stoppani1,2, Alessandra Menon1,2, Luca Pierannunzii2, Riccardo Compagnoni1,2, Pietro S Randelli3,4,5. 1. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. 2. U.O.C. 1a Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy. 3. Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. pietro.randelli@unimi.it. 4. U.O.C. 1a Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy. pietro.randelli@unimi.it. 5. Department of Biomedical Sciences for Health, Research Center for Adult and Pediatric Rheumatic Diseases (RECAP-RD), Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy. pietro.randelli@unimi.it.
Abstract
BACKGROUND: Failure of conservative treatment in patients over 70 years of age with a rotator cuff tear makes surgery a possible option, considering the increase in life expectancy and the high functional demands of elderly patients. The purpose of this systematic review of the literature was to evaluate the subjective and objective outcomes after arthroscopic rotator cuff repair in patients over 70 years of age. METHODS: A systematic review was performed to identify all the studies reporting subjective and objective outcomes in patients aged 70 years or older undergoing arthroscopic rotator cuff repair. Constant Murley Score (CMS), visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), and Simple Shoulder Test (SST) were used to detect any clinical improvement after surgery. Retear and satisfaction were also analyzed. RESULTS: Out of 941 studies identified, only 6 papers have been included in the review. All studies reported improvements in postoperative functional outcome scores that exceed the minimal clinically relevant difference. The mean retear rate amounts to 21.9%, which is in line with the failure rate of rotator cuff repair in general population. Moreover, postoperative satisfaction is very high (95%). CONCLUSION: This systematic review suggests that arthroscopic rotator cuff repair in patients over 70 years of age could be a valid treatment option after failure of conservative approach. LEVEL OF EVIDENCE: 4 Trial registration The study was registered on PROSPERO (registration ID: CRD42018088613).
BACKGROUND: Failure of conservative treatment in patients over 70 years of age with a rotator cuff tear makes surgery a possible option, considering the increase in life expectancy and the high functional demands of elderly patients. The purpose of this systematic review of the literature was to evaluate the subjective and objective outcomes after arthroscopic rotator cuff repair in patients over 70 years of age. METHODS: A systematic review was performed to identify all the studies reporting subjective and objective outcomes in patients aged 70 years or older undergoing arthroscopic rotator cuff repair. Constant Murley Score (CMS), visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), and Simple Shoulder Test (SST) were used to detect any clinical improvement after surgery. Retear and satisfaction were also analyzed. RESULTS: Out of 941 studies identified, only 6 papers have been included in the review. All studies reported improvements in postoperative functional outcome scores that exceed the minimal clinically relevant difference. The mean retear rate amounts to 21.9%, which is in line with the failure rate of rotator cuff repair in general population. Moreover, postoperative satisfaction is very high (95%). CONCLUSION: This systematic review suggests that arthroscopic rotator cuff repair in patients over 70 years of age could be a valid treatment option after failure of conservative approach. LEVEL OF EVIDENCE: 4 Trial registration The study was registered on PROSPERO (registration ID: CRD42018088613).
Entities:
Keywords:
Arthroscopic rotator cuff repair; Patients over 70 years of age; Rotator cuff repair in elderly; Rotator cuff tear; Shoulder arthroscopy
Authors: Nikhil N Verma; Sanjeev Bhatia; Champ L Baker; Brian J Cole; Nicole Boniquit; Gregory P Nicholson; Anthony A Romeo Journal: Arthroscopy Date: 2010-08-21 Impact factor: 4.772
Authors: P-H Flurin; P Hardy; P Abadie; P Boileau; P Collin; J Deranlot; P Desmoineaux; M Duport; J Essig; A Godenèche; T Joudet; J Kany; C Sommaire; C-E Thelu; P Valenti Journal: Orthop Traumatol Surg Res Date: 2013-11-05 Impact factor: 2.256