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Full-thickness rotator cuff tears in patients younger than 55 years: clinical outcome of arthroscopic repair in comparison with older patients

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to examine whether younger patients had a similar response to repair of a full-thickness rotator cuff tear (RCT) as older patients.

Methods

A secondary analysis was conducted of prospectively collected data of patients with full-thickness RCTs. Patients were categorized into patients <55 years of age and patients 55 and older. Patient-related outcome measures of disability at 2 years following surgery were the Short Western Ontario Rotator Cuff (Short WORC), American Shoulder and Elbow Surgeon’s (ASES) assessment form, and absolute Constant–Murley score (ACMS).

Results

Review of the database between 2001 and 2011 identified 344 patients (median age 62, range 24–90). Of these, 83 (24 %) patients were younger than 55 years of age (median age 48, range 24–54) and 261 (76 %) were in the older age group (median age 66, range 55–90). The median follow-up was 24 months (range 23–25). Patients in the younger age group had a higher prevalence of traumatic events (p = 0.02), had sustained more work-related injuries (p < 0.0001), and had a higher ratio of smaller tears (p = 0.0001). No difference was seen between groups with respect to post-operative scores of Short WORC, ASES, or ACMS. Pre-operative scores, having a work-related claim, increased tear size, and concomitant procedures affected the 2-year outcome scores.

Conclusion

This study shows that younger patients with full-thickness RCTs who undergo an arthroscopic repair do as well as older individuals regardless of the measure used to document their recovery.

Level of evidence

Retrospective outcome study, Level II.

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References

  1. Balyk R, Luciak-Corea C, Otto D, Baysal D, Beaupre L (2008) Do outcomes differ after rotator cuff repair for patients receiving workers’ compensation? Clin Orthop Relat Res 466:3025–3033

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Bell S, Lim YJ, Coghlan J (2013) Long-term longitudinal follow-up of mini-open rotator cuff repair. J Bone Joint Surg Am 95:151–157

    Article  PubMed  Google Scholar 

  3. Braune C, von Eisenhart-Rothe R, Welsch F, Teufel M, Jaeger A (2003) Mid-term results and quantitative comparison of postoperative shoulder function in traumatic and non-traumatic rotator cuff tears. Arch Orthop Trauma Surg 123:419–424

    Article  PubMed  Google Scholar 

  4. Burns JP, Snyder SJ (2008) Arthroscopic rotator cuff repair in patients younger than fifty years of age. J Shoulder Elbow Surg 17:90–96

    Article  PubMed  Google Scholar 

  5. Cole BJ, McCarty LP 3rd, Kang RW, Alford W, Lewis PB, Hayden JK (2007) Arthroscopic rotator cuff repair: prospective functional outcome and repair integrity at minimum 2-year follow-up. J Shoulder Elbow Surg 16:579–585

    Article  PubMed  Google Scholar 

  6. Constant CR (1997) An evaluation of the Constant–Murley shoulder assessment. J Bone Joint Surg Br 79:695–696

    CAS  PubMed  Google Scholar 

  7. Cuff DJ, Pupello DR (2012) Prospective evaluation of postoperative compliance and outcomes after rotator cuff repair in patients with and without workers’ compensation claims. J Shoulder Elbow Surg 21:1728–1733

    Article  PubMed  Google Scholar 

  8. DeOrio JK, Cofield RH (1984) Results of a second attempt at surgical repair of a failed initial rotator-cuff repair. J Bone Joint Surg Am 66:563–567

    CAS  PubMed  Google Scholar 

  9. Di Schino M, Augereau B, Nich C (2012) Does open repair of anterosuperior rotator cuff tear prevent muscular atrophy and fatty infiltration? Clin Orthop Relat Res 470:2776–2784

    Article  PubMed Central  PubMed  Google Scholar 

  10. Haahr JP, Ostergaard S, Dalsgaard J, Norup K, Frost P, Lausen S, Holm EA, Andersen JH (2005) Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 64:760–764

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  11. Haviv B, Dolev E, Haber M, Mayo L, Biggs D (2010) Arthroscopic rotator cuff repair: clinical outcome of 607 patients. Knee Surg Sports Traumatol Arthrosc 18:1707–1711

    Article  PubMed  Google Scholar 

  12. Hawkins RJ, Misamore GW, Hobeika PE (1985) Surgery for full-thickness rotator-cuff tears. J Bone Joint Surg Am 67:1349–1355

    CAS  PubMed  Google Scholar 

  13. Hawkins RJ, Morin WD, Bonutti PM (1999) Surgical treatment of full-thickness rotator cuff tears in patients 40 years of age or younger. J Shoulder Elbow Surg 8:259–265

    Article  CAS  PubMed  Google Scholar 

  14. Hayes K, Walton JR, Szomor ZL, Murrell GA (2002) Reliability of 3 methods for assessing shoulder strength. J Shoulder Elbow Surg 11:33–39

    Article  PubMed  Google Scholar 

  15. Henn RF 3rd, Kang L, Tashjian RZ, Green A (2008) Patients with workers’ compensation claims have worse outcomes after rotator cuff repair. J Bone Joint Surg Am 90:2105–2113

    Article  PubMed  Google Scholar 

  16. Holtby R, Razmjou H (2010) Impact of work-related compensation claims on surgical outcome of patients with rotator cuff related pathologies: a matched case-control study. J Shoulder Elbow Surg 19:452–460

    Article  PubMed  Google Scholar 

  17. Krishnan SG, Harkins DC, Schiffern SC, Pennington SD, Burkhead WZ (2008) Arthroscopic repair of full-thickness tears of the rotator cuff in patients younger than 40 years. Arthroscopy 24:324–328

    Article  PubMed  Google Scholar 

  18. Lin EC, Mall NA, Dhawan A, Sherman SL, McGill KC, Provencher MT, Nicholson GP, Cole BJ, Solomon DJ, Verma NN, Romeo AA (2013) Arthroscopic primary rotator cuff repairs in patients aged younger than 45 years. Arthroscopy 29:811–817

    Article  PubMed  Google Scholar 

  19. Ma HL, Wu JJ, Lin CF, Lo WH (2000) Surgical treatment of full thickness rotator cuff tear in patients younger than 40 years. Zhonghua Yi Xue Za Zhi (Taipei) 63:452–458

    CAS  Google Scholar 

  20. Mall NA, Lee AS, Chahal J, Sherman SL, Romeo AA, Verma NN, Cole BJ (2013) An evidenced-based examination of the epidemiology and outcomes of traumatic rotator cuff tears. Arthroscopy 29:366–376

    Article  PubMed  Google Scholar 

  21. Michener LA, McClure PW, Sennett BJ (2002) American shoulder and elbow surgeons standardized shoulder assessment form, patient self-report section: reliability, validity, and responsiveness. J Shoulder Elbow Surg 11:587–594

    Article  PubMed  Google Scholar 

  22. Millett PJ, Warth RJ, Dornan GJ, Lee JT, Spiegl UJ (2014) Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials. J Shoulder Elbow Surg 23:586–597

    Article  PubMed  Google Scholar 

  23. Murray TF Jr, Lajtai G, Mileski RM, Snyder SJ (2002) Arthroscopic repair of medium to large full-thickness rotator cuff tears: outcome at 2- to 6-year follow-up. J Shoulder Elbow Surg 11:19–24

    Article  PubMed  Google Scholar 

  24. Razmjou H, Bean A, Macdermid JC, van Osnabrugge V, Travers N, Holtby R (2008) Convergent validity of the Constant–Murley outcome measure in patients with rotator cuff disease. Physiother Can 60:72–79

    Article  PubMed Central  PubMed  Google Scholar 

  25. Razmjou H, Bean A, van Osnabrugge V, MacDermid JC, Holtby R (2006) Cross-sectional and longitudinal construct validity of two rotator cuff disease-specific outcome measures. BMC Musculoskelet Disord 7:26

    Article  PubMed Central  PubMed  Google Scholar 

  26. Razmjou H, Stratford P, Holtby R (2012) A shortened version of the Western Ontario rotator cuff disability index: development and measurement properties. Physiother Can 64:135–144

    Article  PubMed Central  PubMed  Google Scholar 

  27. Richards RR, An KN, Bigliani LU, Friedman RJ, Gartsman GM, Gristina AG, Iannotti JP, Mow VC, Sidles JA, Zuckerman JD (1994) A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 3:347–352

    Article  CAS  PubMed  Google Scholar 

  28. Sher JS, Uribe JW, Posada A, Murphy BJ, Zlatkin MB (1995) Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am 77:10–15

    CAS  PubMed  Google Scholar 

  29. Shin SJ (2012) A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy 28:25–33

    Article  PubMed  Google Scholar 

  30. Sperling JW, Cofield RH, Schleck C (2004) Rotator cuff repair in patients fifty years of age and younger. J Bone Joint Surg Am 86-A:2212–2215

    PubMed  Google Scholar 

  31. van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, Lindenburg R, Swen JW, van Arkel ER (2013) Clinical outcome in all-arthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: a randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy 29:266–273

    Article  PubMed  Google Scholar 

  32. Vastamaki M, Lohman M, Borgmastars N (2013) Rotator cuff integrity correlates with clinical and functional results at a minimum 16 years after open repair. Clin Orthop Relat Res 471:554–561

    Article  PubMed Central  PubMed  Google Scholar 

  33. Watson EM, Sonnabend DH (2002) Outcome of rotator cuff repair. J Shoulder Elbow Surg 11:201–211

    Article  PubMed  Google Scholar 

  34. Zandi H, Coghlan JA, Bell SN (2006) Mini-incision rotator cuff repair: a longitudinal assessment with no deterioration of result up to nine years. J Shoulder Elbow Surg 15:135–139

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. University of Toronto Orthopaedic Sports Medicine, Toronto, Canada

    Tim Dwyer & Richard Holtby

  2. Women’s College and Mt Sinai Hospital, 76 Grenville St, Toronto, M5S1B1, Canada

    Tim Dwyer

  3. Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada

    Helen Razmjou & Richard Holtby

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  1. Tim Dwyer
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  2. Helen Razmjou
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  3. Richard Holtby
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Correspondence to Tim Dwyer.

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Dwyer, T., Razmjou, H. & Holtby, R. Full-thickness rotator cuff tears in patients younger than 55 years: clinical outcome of arthroscopic repair in comparison with older patients. Knee Surg Sports Traumatol Arthrosc 23, 508–513 (2015). https://doi.org/10.1007/s00167-014-3094-2

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