Rotator cuff surgery in patients older than 75 years with large and massive tears
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...
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Veröffentlicht in: | Journal of shoulder and elbow surgery 2017-02, Vol.26 (2), p.265-272 |
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container_title | Journal of shoulder and elbow surgery |
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creator | Jung, Hong Jun, MD Sim, Gyeong-Bo, MD Bae, Kun Hyung, MD Kekatpure, Aashay L., MBBS, DNB Chun, Jae-Myeung, MD Jeon, In-Ho, MD |
description | 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 |
doi_str_mv | 10.1016/j.jse.2016.07.004 |
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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.</description><identifier>ISSN: 1058-2746</identifier><identifier>EISSN: 1532-6500</identifier><identifier>DOI: 10.1016/j.jse.2016.07.004</identifier><identifier>PMID: 27720414</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Activities of Daily Living ; Age Factors ; Aged ; Arthroplasty, Replacement, Shoulder - methods ; Female ; functional outcome ; geriatric population ; Health Services for the Aged ; Humans ; Injury Severity Score ; Magnetic Resonance Imaging ; Male ; morbidity ; Orthopedics ; Postoperative Period ; retear ; Retrospective Studies ; Rotator Cuff Injuries - diagnostic imaging ; Rotator Cuff Injuries - surgery ; rotator cuff repair ; rotator cuff tear ; Shoulder ; Treatment Outcome ; Visual Analog Scale</subject><ispartof>Journal of shoulder and elbow surgery, 2017-02, Vol.26 (2), p.265-272</ispartof><rights>Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>2017 Journal of Shoulder and Elbow Surgery Board of Trustees</rights><rights>Copyright © 2017 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-2f65506604d59d93ab84b2df40a727cd6f48bbd12444ff954e774e4bb89ea053</citedby><cites>FETCH-LOGICAL-c408t-2f65506604d59d93ab84b2df40a727cd6f48bbd12444ff954e774e4bb89ea053</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jse.2016.07.004$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,780,784,3550,27924,27925,45995</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27720414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Jung, Hong Jun, MD</creatorcontrib><creatorcontrib>Sim, Gyeong-Bo, MD</creatorcontrib><creatorcontrib>Bae, Kun Hyung, MD</creatorcontrib><creatorcontrib>Kekatpure, Aashay L., MBBS, DNB</creatorcontrib><creatorcontrib>Chun, Jae-Myeung, MD</creatorcontrib><creatorcontrib>Jeon, In-Ho, MD</creatorcontrib><title>Rotator cuff surgery in patients older than 75 years with large and massive tears</title><title>Journal of shoulder and elbow surgery</title><addtitle>J Shoulder Elbow Surg</addtitle><description>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.</description><subject>Activities of Daily Living</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Arthroplasty, Replacement, Shoulder - methods</subject><subject>Female</subject><subject>functional outcome</subject><subject>geriatric population</subject><subject>Health Services for the Aged</subject><subject>Humans</subject><subject>Injury Severity Score</subject><subject>Magnetic Resonance Imaging</subject><subject>Male</subject><subject>morbidity</subject><subject>Orthopedics</subject><subject>Postoperative Period</subject><subject>retear</subject><subject>Retrospective Studies</subject><subject>Rotator Cuff Injuries - diagnostic imaging</subject><subject>Rotator Cuff Injuries - surgery</subject><subject>rotator cuff repair</subject><subject>rotator cuff tear</subject><subject>Shoulder</subject><subject>Treatment Outcome</subject><subject>Visual Analog Scale</subject><issn>1058-2746</issn><issn>1532-6500</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU2L1TAUhoMozof-ADeSpZvWkzRpWgRBBnWEAZlx9iFNTpzU3vaapCP335tyRxezmFUO5HlfOM8h5A2DmgFr34_1mLDmZaxB1QDiGTllsuFVKwGelxlkV3El2hNyltIIAL0A_pKccKU4CCZOyfXNkk1eIrWr9zSt8SfGAw0z3ZsccM6JLpPDSPOdmamS9IAmJvon5Ds6mQJTMzu6MymFe6R5-3xFXngzJXz98J6T2y-fby8uq6vvX79dfLqqrIAuV9y3UkLbgnCyd31jhk4M3HkBRnFlXetFNwyOcSGE970UqJRAMQxdjwZkc07eHWv3cfm9Ysp6F5LFaTIzLmvSrGtk03PBVUHZEbVxSSmi1_sYdiYeNAO9idSjLiL1JlKD0kVkybx9qF-HHbr_iX_mCvDhCGDZ8T5g1MkWYRZdiGizdkt4sv7jo7SdwhysmX7hAdO4rHEu8jTTiWvQP7ZLbodkbQO8Ybz5CyJQl5U</recordid><startdate>20170201</startdate><enddate>20170201</enddate><creator>Jung, Hong Jun, MD</creator><creator>Sim, Gyeong-Bo, MD</creator><creator>Bae, Kun Hyung, MD</creator><creator>Kekatpure, Aashay L., MBBS, DNB</creator><creator>Chun, Jae-Myeung, MD</creator><creator>Jeon, In-Ho, MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170201</creationdate><title>Rotator cuff surgery in patients older than 75 years with large and massive tears</title><author>Jung, Hong Jun, MD ; Sim, Gyeong-Bo, MD ; Bae, Kun Hyung, MD ; Kekatpure, Aashay L., MBBS, DNB ; Chun, Jae-Myeung, MD ; Jeon, In-Ho, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-2f65506604d59d93ab84b2df40a727cd6f48bbd12444ff954e774e4bb89ea053</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Activities of Daily Living</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Arthroplasty, Replacement, Shoulder - methods</topic><topic>Female</topic><topic>functional outcome</topic><topic>geriatric population</topic><topic>Health Services for the Aged</topic><topic>Humans</topic><topic>Injury Severity Score</topic><topic>Magnetic Resonance Imaging</topic><topic>Male</topic><topic>morbidity</topic><topic>Orthopedics</topic><topic>Postoperative Period</topic><topic>retear</topic><topic>Retrospective Studies</topic><topic>Rotator Cuff Injuries - diagnostic imaging</topic><topic>Rotator Cuff Injuries - surgery</topic><topic>rotator cuff repair</topic><topic>rotator cuff tear</topic><topic>Shoulder</topic><topic>Treatment Outcome</topic><topic>Visual Analog Scale</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Jung, Hong Jun, MD</creatorcontrib><creatorcontrib>Sim, Gyeong-Bo, MD</creatorcontrib><creatorcontrib>Bae, Kun Hyung, MD</creatorcontrib><creatorcontrib>Kekatpure, Aashay L., MBBS, DNB</creatorcontrib><creatorcontrib>Chun, Jae-Myeung, MD</creatorcontrib><creatorcontrib>Jeon, In-Ho, MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of shoulder and elbow surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Jung, Hong Jun, MD</au><au>Sim, Gyeong-Bo, MD</au><au>Bae, Kun Hyung, MD</au><au>Kekatpure, Aashay L., MBBS, DNB</au><au>Chun, Jae-Myeung, MD</au><au>Jeon, In-Ho, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Rotator cuff surgery in patients older than 75 years with large and massive tears</atitle><jtitle>Journal of shoulder and elbow surgery</jtitle><addtitle>J Shoulder Elbow Surg</addtitle><date>2017-02-01</date><risdate>2017</risdate><volume>26</volume><issue>2</issue><spage>265</spage><epage>272</epage><pages>265-272</pages><issn>1058-2746</issn><eissn>1532-6500</eissn><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.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>27720414</pmid><doi>10.1016/j.jse.2016.07.004</doi><tpages>8</tpages></addata></record> |
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subjects | Activities of Daily Living Age Factors Aged Arthroplasty, Replacement, Shoulder - methods Female functional outcome geriatric population Health Services for the Aged Humans Injury Severity Score Magnetic Resonance Imaging Male morbidity Orthopedics Postoperative Period retear Retrospective Studies Rotator Cuff Injuries - diagnostic imaging Rotator Cuff Injuries - surgery rotator cuff repair rotator cuff tear Shoulder Treatment Outcome Visual Analog Scale |
title | Rotator cuff surgery in patients older than 75 years with large and massive tears |
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