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Clin Shoulder Elbow > Volume 15(2); 2012 > Article
Clinics in Shoulder and Elbow 2012;15(2):91-98.
DOI: https://doi.org/10.5397/CiSE.2012.15.2.91    Published online December 31, 2012.
Repair of Large to Massive Rotator Cuff Tears in the Elderly Patients
Hong Jun Jung, Jae Myeung Chun, In Ho Jeon, Jun Kwon, Sang Ho Ha, Sung Wook Yang, Ji Ho Lee
1Department of Orthopedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea. jeonchoi@gmail.com
2Department of Orthopedic Surgery, National Police Hospital, Seoul, Korea.
3Department of Orthopaedic Surgery, Upper Extremity and Microsurgery Center, Semyeng Christianity Hospital, Pohang, Korea.
65세 이상 고령 환자의 대형 및 광범위 회전근 개 파열에 대한 봉합술
정홍준*·전재명·전인호·권 준·하상호·양성욱*·이지호
울산대학교 의과대학 서울아산병원 정형외과학교실, 국립경찰병원 정형외과*
포항세명기독병원 정형?성형센터
Abstract
PURPOSE
The objective of this study is to evaluate the functional outcome and identify prognosis of re-tear patients in patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear. MATERIALS AND METHODS: From 1995 September to 2010 March, 147 patients aged 65years or over (40 male, 107 female, with an average age of 69.6) undergoing surgical repair for large to massive full thickness rotator cuff tear (large 67 cases, massive 80 cases). For functional evaluation, preoperative and postoperative 1 year range of motion and muscle power checked. For subjective evaluation, American shoulder and elbow surgeons score and Constant score were checked. For anatomical evaluation, 87 patients were checked shoulder MRI at the time of the postoperative 1 year.
RESULTS
ASES score improved from to 50.4 to 88.9, Constant score improved from 47.1 to 75.2. Supraspinatus power improved from 51.1% to 80.8%, external rotator muscle power improved from 64.5% to 83.1%. Forward elevation improved from 117.4 degrees to 153 degrees, external rotation improved from 23.6 degrees to 41.8 degrees. Follow up MRI showed re-tear in 23%, all re-tear patients were from massive tear except one patient. All re-tear patients showed improved clinical outcomes, but supraspinatus and external rotator muscle power were not improved.
CONCLUSIONS
Patients aged 65 years or over undergoing surgical repair for a large to massive full-thickness rotator cuff tear showed successful outcomes over 90 percent. Re-tear patients also showed successful clinical outcomes. In elderly patients with large to massive full thickness rotator cuff tear, aggressive surgical repair leads good clinical outcomes.
Key Words: Rotator cuff tear; Old age; Rotator cuff repair


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