title: Rotator cuff surgery in patients older than 75 years with large and massive tears.
abstract: BACKGROUND
  The purpose of this study was to evaluate whether rotator cuff repair improves subjective and functional outcomes in patients aged ≥75 years.
  
  
  METHODS
  From May 2005 to March 2013, 121 elderly patients who underwent rotator cuff repair for large and massive rotator cuff tears were evaluated retrospectively. Patients with an American Society of Anesthesiologists physical status classification system grade ≥4 were excluded. The patients were evaluated using visual analog scales, subjective satisfaction surveys, American Shoulder and Elbow Surgeons scores, and Constant scores. The Katz index of activity of daily living (ADL) and functional independence measure motor score were used to evaluate ADLs. Postoperative magnetic resonance imaging (MRI) was performed to investigate the structural integrity of repaired cuffs.
  
  
  RESULTS
  In total, 64 patients were enrolled in the study; 80% were satisfied with their results. Visual analog scale scores improved from 6.4 to 2.3, American Shoulder and Elbow Surgeons scores from 42 to 84, and Constant scores from 42 to 76. Katz ADL scores improved from 3.4 to 5.0. Functional independence measure motor score improved from 22 to 51. Of the 64 patients, 46 underwent MRI 1 year postoperatively. Follow-up MRI revealed retears in 26% of patients. All patients with retears had improved subjective outcomes and functional scores. No patients died or experienced complications requiring intensive care or extended hospitalization.
  
  
  CONCLUSIONS
  Surgical treatment for large to massive rotator cuff tears in elderly patients with American Society of Anesthesiologists grade <4 provides good functional outcomes without morbidity, even in those with retears.
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Hong Jun
authors.initials: HJ
authors.lastname: Jung
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Gyeong-Bo
authors.initials: GB
authors.lastname: Sim
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Kun Hyung
authors.initials: KH
authors.lastname: Bae
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Aashay L
authors.initials: AL
authors.lastname: Kekatpure
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea.
authors.forename: Jae-Myeung
authors.initials: JM
authors.lastname: Chun
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, School of Medicine, University of Ulsan, Seoul, Republic of Korea. Electronic address: jeonchoi@gmail.com.
authors.forename: In-Ho
authors.initials: IH
authors.lastname: Jeon
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000072228:Arthroplasty, Replacement, Shoulder / Q000379:methods; D005260:Female; D006299:Health Services for the Aged; D006801:Humans; D015601:Injury Severity Score; D008279:Magnetic Resonance Imaging; D008297:Male; D011184:Postoperative Period; D012189:Retrospective Studies; D000070636:Rotator Cuff Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: Shoulder; functional outcome; geriatric population; morbidity; retear; rotator cuff repair; rotator cuff tear