title: Arthroscopic repair of the rotator cuff: prospective study of tendon healing after 70 years of age in 145 patients.
abstract: BACKGROUND
  The level of activity of patients older than 70 years is tending to increase, as are their expectations in terms of joint function recuperation. It has not been proven that rotator cuff repair healing is satisfactory in the elderly. The main hypothesis of this study was: repair of supraspinous lesions in patients older than 70 years is reliable in terms of both clinical results and healing. The secondary hypothesis was: tendon healing is significantly correlated with the Constant, ASES, and SST scores as well as with age, tendon retraction, and fatty infiltration.
  
  
  METHODS
  Multicenter prospective study on 145 patients older than 70 years, with 135 patients reviewed at 1 year (93%). The mean age was 73.9 years. Full-thickness tears of the supraspinatus extended at most to the upper third of the infraspinatus and retraction limited to Patte stages 1 and 2 were included. Clinical assessment was carried out in accordance with the Constant, ASES, and SST scores. Healing was evaluated with ultrasound.
  
  
  RESULTS
  A significant improvement was noted in the Constant (44/76)+31.5 (P<0.0001), ASES (35/90)+54.4 (P<0.0001), and SST (3.5/10)+6.6 (P>0.0001) scores at 1 year of follow-up. The healing rate was 89% with 15 re-tears, nine of which were stage 1 and six stage 2. The clinical result was not correlated with patient age (Constant, P=0.24; ASES, P=0.38; SST, P=0.83) nor with the retraction stage (Constant, P=0.71; ASES, P=0.35; SST, P=0.69) or the stage of fatty infiltration (P>0.7). Healing was correlated with the quality of the clinical result (Constant, P=0.02; ASES, P=0.03) and age (P=0.01) but was not correlated with retraction or the fatty infiltration stage (P>0.3).
  
  
  CONCLUSIONS
  Arthroscopic repair significantly improves the clinical results, even in patients older than 70 years. The clinical results are not correlated with age (but deterioration of the result was not noted after 75 years) or frontal retraction (but the study only included retractions limited to stages 1 and 2). The healing rate is satisfactory, but this study is limited to small ruptures of the supraspinatus, and the postoperative ultrasound analysis probably inferior to CT imaging with contrast agent injection, often used as the reference. Healing proves to be correlated with the quality of the clinical result and patient age.
authors.affiliation: Clinique du Sport de Bordeaux-Mérignac, 2, rue Georges-Negrevergne, 33700 Mérignac, France. Electronic address: phflurin@gmail.com.
authors.forename: P-H
authors.initials: PH
authors.lastname: Flurin
authors.forename: P
authors.initials: P
authors.lastname: Hardy
authors.forename: P
authors.initials: P
authors.lastname: Abadie
authors.forename: P
authors.initials: P
authors.lastname: Boileau
authors.forename: P
authors.initials: P
authors.lastname: Collin
authors.forename: J
authors.initials: J
authors.lastname: Deranlot
authors.forename: P
authors.initials: P
authors.lastname: Desmoineaux
authors.forename: M
authors.initials: M
authors.lastname: Duport
authors.forename: J
authors.initials: J
authors.lastname: Essig
authors.forename: A
authors.initials: A
authors.lastname: Godenèche
authors.forename: T
authors.initials: T
authors.lastname: Joudet
authors.forename: J
authors.initials: J
authors.lastname: Kany
authors.forename: C
authors.initials: C
authors.lastname: Sommaire
authors.forename: C-E
authors.initials: CE
authors.lastname: Thelu
authors.forename: P
authors.initials: P
authors.lastname: Valenti
mesh_terms: D000367:Age Factors; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011446:Prospective Studies; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D018570:Risk Assessment; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D013708:Tendon Injuries / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome; D014945:Wound Healing / Q000502:physiology
keywords: Arthroscopy; Full-thickness tear; Rotator cuff healing; Shoulder