| Abstract ID |
| 20260044 |
| Category |
| Shoulder: Rotator Cuff |
| Preferable Presentation |
| Oral Presentation |
| Title |
| COMPARISON OF ARTHROSCOPIC ROTATOR CUFF REPAIR IN YOUNG PATIENTS LESS THAN 45 VERSUS ELDERLY PATIENTS AGED OVER 80 YEARS |
| Author |
|
| Presenter |
| joo han oh |
| Abstract |
| Background and objectives: This study aimed to analyze the anatomical characteristics and functional outcomes of arthroscopic rotator cuff repair (ARCR) between young patients (≤ 45 years, yRCT) and elderly patients (≥ 80 years, eRCT) to elucidate age-specific pathomechanisms and prognosis. Study design: We retrospectively reviewed patients who underwent ARCR by a single surgeon between 2014 and 2023. We compared 26 elderly (eRCT group) and 53 young (yRCT group) atraumatic RCT patients. Subjective and functional outcomes, including visual analog scales for pain (pVAS), American Shoulder and Elbow Surgeons (ASES) scores, Simple Shoulder Test (SST), and Constant scores, were assessed preoperatively and at a minimum 12-month follow-up. Tendon integrity was evaluated using sonography at 6 months or MRI at 12 months postoperatively. A multivariate logistic regression analysis was performed to identify independent risk factors for postoperative retear. Results: The mean age was 41.3 years in the yRCT group and 81.5 years in the eRCT group. The yRCT group exhibited significantly greater acromion thickness (p=0.023), whereas the eRCT group had higher prevalence of subacromial spurs (96.2% vs. 69.8%, p=0.008). The eRCT group presented with significantly more severe preoperative pathology, including larger tear sizes and a higher prevalence of fatty infiltration (all p < .001). At the final follow-up, no significant differences were found in the amount of improvement (Δ) for pVAS, ASES score, SST, and Constant scores between the groups. The absolute rate of retear was significantly higher in the eRCT group (19.2%) compared to the yRCT group (1.9%) (p = 0.013). However, multivariate logistic regression analysis revealed that concomitant subscapularis tear involvement (OR = 8.140) and a larger preoperative anteroposterior tear dimension (OR = 1.063) were significant independent predictors of a postoperative retear, whereas patient age was not. Conclusion: In non-traumatic young patients, the observed acromial morphology implies that congenital factors may play a contributing role in the pathogenesis of rotator cuff tears. However, this study demonstrates that advanced age itself is not a determinant of surgical failure. After accounting for anatomical tear characteristics, patient age was not found to be an independent predictor of retear. These findings indicate that age alone should not be a contraindication for ARCR, as elderly patients can achieve meaningful functional recovery and satisfaction. |