CLINICAL OUTCOME OF ARTHROSCOPIC ROTATOR CUFF REPAIR IN PATIENTS 2 AGED 70 YEARS AND OLDER

Abstract

Aim: The purpose of this study was to evaluate the outcome of arthroscopic rotator cuff 13 repair in patients aged 70 years or older and report our results in terms of pain, range of 14 motion, muscle strength, and functional outcome. 15 Materials and Methods: We performed retrospective data review and identified 97 16 shoulders (94 patients) of our interest with minimum 24 months of follow-up. All patients 17 were evaluated with Visual Analogue Scale (VAS), Range of motion (ROM), Manual 18 Muscle Strength, and Oxford Shoulder Score (OSS) preoperatively and at final follow-up. 19 Patient satisfaction was determined by asking patients whether they were satisfied (yes 20 or no). Statistical analysis was performed using paired t test to compare pre and 21 postoperative measures and Mann-Whitney U test to see the effect of age and gender on 22 the final outcome. 23 Results: Of 97 shoulders, 70 (67.9%) shoulders were available for final evaluation with 24 a mean age of 73.56 years (70 to 81) and mean follow-up of 57.52 months (24 to 122). 25 Mean VAS for pain was improved from 8.4 (6 to 10) to 1.04 (0 to 5) (P < 0.001) at final 26 follow-up. Mean forward flexion, abduction, external rotation increased from 112.50º to 27 165.43º (P < 0.001), 114.36º to 166.86º (P < 0.001), 45.14º to 73.64º (P <0.001) 28 respectively, as well as, Internal rotation also improved in 55 patients (78.5%, n = 70) at 29 final follow-up. Mean muscle strength of Supraspinatus (SSP) and Infraspinatus (ISP) 30 according to MRC scale was significantly improved (P < 0.05) from 2.84 (2 to 4) to 4.67 31 (4 to 5) and from 2.77 (2 to 4) to 4.64 (3 to 5) at the final follow-up respectively. Mean 32 OSS was improved from 11.49 to 44.40 (P < 0.001) and only three patients (4.28%, n = 33 70) were subjectively less than satisfied at final follow-up. 34 Conclusions: There was a significant improvement in shoulder function with a low 35 complication rate. Hence, we have no hesitation to recommend repair in this age group. 36 Provided the rotator cuff is not grossly wasted, and patient is fit to undergo surgery, age 37 should not be the criteria for determining repairability.