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Orthop Traumatol Surg Res. 2011 Oct;97(6 Suppl):S125-30. doi: 10.1016/j.otsr.2011.06.006. Epub 2011 Jul 27.

Arthroscopic treatment of rotator cuff tear in the over-60s: repair is preferable to isolated acromioplasty-tenotomy in the short term.

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1
Emile-Gallé Surgery Center, 49, rue Hermite, 54000 Nancy, France.

Abstract

INTRODUCTION:

The principal study objective was to compare clinical results for arthroscopic repair of rotator cuff tear and acromioplasty-tenotomy in patients aged over 60 years.

HYPOTHESES:

Repair provides better clinical results than isolated acromioplasty-tenotomy. Shoulder function is improved when healing is obtained.

PATIENTS AND METHODS:

One hundred and forty-two patients aged over 60 years (mean age, 67 years) presenting with reparable supraspinatus tear, extending to a greater or lesser degree to the infraspinatus, agreed to take part in a randomized prospective study. Fifteen were excluded from statistical analysis. All underwent acromioplasty and biceps tenotomy. They were randomly assigned to arthroscopic rotator-cuff repair (CR group) or not (AT group). The principal evaluation criterion was mean weighted Constant score at one year's follow-up. Healing in the CR group was assessed on ultrasound at one year.

RESULTS:

The complications rate was 7.9%. Mean weighted Constant score was significantly better in group CR: 75.8%, versus 68.8% in AT. In the CR group, the 1-year healing rate was 67.6%. Healing significantly impacted mean weighted Constant score: 80% with healing, versus 66.9% in iterative tearing. Whatever the size of the tear, mean weighted Constant score was significantly better in patients with than without (no repair or iterative tear) tendon healing.

DISCUSSION:

The study demonstrated the interest of arthroscopic rotator cuff repair in patients aged over 60 years. The benefit of repair compared to isolated acromioplasty-tenotomy depended on tendon healing.

LEVEL OF EVIDENCE:

Randomized prospective study, level II.

PMID:
21798838
DOI:
10.1016/j.otsr.2011.06.006
[Indexed for MEDLINE]
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