title: Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients.
abstract: BACKGROUND
  The purpose of this study was to conduct a systematic review of the literature to evaluate the characteristics of injury and treatment outcomes of rotator cuff tears in young patients.
  
  
  METHODS
  A systematic electronic search was performed for clinical studies evaluating rotator cuff tears in patients younger than 40 years with special emphasis on reporting of injury characteristics and treatment outcomes with a minimum 1-year follow-up.
  
  
  RESULTS
  Twelve studies (involving 336 patients) met inclusion criteria. The mean age of the patients was 28 years (range, 16-40 years), with a mean follow-up of 39 months. There were 2 distinct subgroups. The majority of studies (7 of 10) showed that patients typically had a full-thickness tear with an acute traumatic etiology. However, within the subgroup of elite throwers, 5 of 6 studies demonstrated a majority of tears that were partial thickness stemming from chronic overuse. Rotator cuff repair improved pain and strength in almost all studies reporting on these parameters. Eighty-seven percent of patients reported they were satisfied. However, all studies examining elite throwers showed significant difficulty in returning to play (25%-97%).
  
  
  CONCLUSIONS
  In young patients with rotator cuff tears, there are 2 primary groups. (1) A majority group with rotator cuff tears of traumatic origin responded well to both arthroscopic and open rotator cuff repair in terms of pain relief and self-reported outcomes postoperatively. These patients reported high levels of satisfaction and return to preinjury level of play. (2) A unique subpopulation composed of elite throwers had improved outcomes but suboptimal return to play.
authors.affiliation: School of Medicine, Duke University, Durham, NC, USA.
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Lazarides
authors.affiliation: Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Durham, NC, USA.
authors.forename: Eduard
authors.initials: E
authors.lastname: Alentorn-Geli
authors.affiliation: Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Durham, NC, USA.
authors.forename: J H James
authors.initials: JH
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Durham, NC, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Stuart
authors.affiliation: Department of Surgery, University of Calgary, Calgary, AB, Canada.
authors.forename: Ian K Y
authors.initials: IK
authors.lastname: Lo
authors.affiliation: Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Durham, NC, USA.
authors.forename: Grant E
authors.initials: GE
authors.lastname: Garrigues
authors.affiliation: Department of Orthopaedic Surgery, Duke Sports Sciences Institute, Durham, NC, USA. Electronic address: dean.taylor@dm.duke.edu.
authors.forename: Dean C
authors.initials: DC
authors.lastname: Taylor
mesh_terms: D000367:Age Factors; D001182:Arthroscopy; D012090:Cumulative Trauma Disorders / Q000150:complications; D006801:Humans; D017060:Patient Satisfaction; D000068958:Return to Sport; D062707:Return to Work; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries
keywords: Rotator cuff tear; athletes; elite throwers; rotator cuff repair; young people; younger than 40