Rotator cuff tears are a common cause of shoulder dysfunction, especially in patients older than 70 years of age. The prevalence of full-thickness rotator cuff tears increases with age, with a report indicating that they may occur in up to 22% of all patients over 65 years of age. Elderly individuals have shown an increasing desire to remain physically active. These expectations often warrant surgical treatment of rota- tor cuff tears in this population after failure of nonoperative management. However, controversy exists regarding surgical indications as well as the optimal operative technique.
Older individuals have a number of factors that work against obtaining good results after surgery. For example, patients older than 60 years are 3 times more likely to experience massive rotator cuff tears compared with younger patients. Bone quality also decreases with age and may complicate suture anchor fixation. Lamellar dissection and fatty infiltration are more common in elderly individuals. Healing may be impaired by poor blood supply, as histologic examination of rotator cuff tendon tissue has shown decreased vascularity in older patients. Furthermore, comorbid conditions such as diabetes, rheumatoid arthritis, and renal disease are more prevalent in older individuals. All of the aforementioned factors can make rotator cuff repair more challenging and clinical out- comes less predictable.
Rotator cuff repair has shown superior results when compared with debridement alone in patients over 70 years old. Historically, favorable clinical outcomes have been reported for open and mini-open rotator cuff repairs and more recently for arthroscopic repairs in the general elderly population. This study aims to evaluate clinical outcomes in recreational athletes 70 years of age or older.