Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review

Authors

  • Bruno Mota Silva Orthopaedic Department. Hospital de Nossa Senhora do Rosário. Barreiro. Portugal. Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.
  • António Cartucho Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.
  • Marco Sarmento Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.
  • Nuno Moura Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.

DOI:

https://doi.org/10.20344/amp.8307

Keywords:

Aged, Arthroscopy, Rotator Cuff Injuries/surgery, Systematic Review

Abstract

Introduction: The objective of this study was to analyze current evidence regarding surgical management of rotator cuff tears in patients of 65 years of age and above. Our hypothesis was that surgical repair of rotator cuff tears, in patients older than 65 years, conveys good outcome scores. We have not found a similar systematic review in current literature.
Material and Methods: Medline®, PubMed, Scopus, and the Cochrane Register of Controlled Trials were searched from January 1999 unto December 2015 for studies, regardless of language, including the words ‘rotator cuff’ and ‘65 years’ or ‘70 years’. Inclusion criteria were studies (level I to IV) that reported clinical outcomes in patients older than 65 years, having undertaken surgical repair of a symptomatic rotator cuff tears. Arthroscopic, mini open and open techniques were included. Exclusion criteria were: studies with patients younger than 65 years, studies that did not use validated outcome evaluation scores as primary assessment tools and those with follow up under one year. This work followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses - PRISMA guidelines. Data abstracted included patient demographics, tear pattern, surgical procedures, clinical and repair results. Outcome scores were converted to percentages, allowing comparison of data between studies.
Results: After deep analysis, 14 studies met the inclusion criteria: 11 level IV studies, 1 level III study and 2 level II studies. Seven studies found statistically significant outcome improvements between pre and postoperative evaluations. All studies reported good or excellent surgical outcomes.
Discussion: Better results would probably be achieved if all studies had rigorous and homogeneous patient selection criteria, but the fact is, that even though this was not the case, the clinical scores remained favorable, and with statistically significant outcome improvement in all studies with prospectively collected data.
Conclusion: Based on current literature, rotator cuff repair in patients older than 65 years imparts favorable improvement in clinical outcome scores and overall patient satisfaction.

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Author Biographies

Bruno Mota Silva, Orthopaedic Department. Hospital de Nossa Senhora do Rosário. Barreiro. Portugal. Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.

M.D., Orthopaedic Department, Hospital do Barreiro

António Cartucho, Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.

M.D., Head of Shoulder Unit

Orthopaedic Surgery, Hospital CUF Descobertas

Marco Sarmento, Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.

M.D., Shoulder Unit

Orthopaedic Surgery, Hospital CUF Descobertas

Nuno Moura, Shoulder Unit, Orthopaedic Surgery. Hospital CUF Descobertas. Lisboa. Portugal.

M.D., Shoulder Unit

Orthopaedic Surgery, Hospital CUF Descobertas

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Published

2017-04-28

How to Cite

1.
Silva BM, Cartucho A, Sarmento M, Moura N. Surgical Treatment of Rotator Cuff Tears After 65 Years of Age: A Systematic Review. Acta Med Port [Internet]. 2017 Apr. 28 [cited 2023 Feb. 1];30(4):320-9. Available from: https://actamedicaportuguesa.com/revista/index.php/amp/article/view/8307

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Section

Review Articles