Repair of massive rotator cuff tears in patients older than 70 years

Major ruptures of the rotator cuff are common in elderly patients, and their management has been a challenge for orthopaedic surgeons. This study was undertaken to evaluate the results obtained in patients older than 70 years who were treated with open surgical repair for massive ruptures of the rotator cuff tendons and to correlate the functional outcomes with the quality of the repairs. Between January 1991 and November 1994, 69 patients older than 70 years of age underwent rotator cuff repairs of massive tears with a minimum follow-up of 2 years (mean of 3 years). These patients were evaluated before and after surgery with the University of California at Los Angeles score. The mean age was 75 years (range 70 to 90 years), and female sex and right shoulder were predominant. A good bone-tendon repair was achieved in 55 patients, a fair bone-tendon repair in 5 patients, a poor bone tendon-repair in 8 patients, and 1 patient had no repair. The mean University of California at Los Angeles rating score before surgery was 9.4 points, and the mean postoperative score at final follow-up was 30.9 points, with an average improvement of 21.5 points (P = .0001). Satisfactory results were achieved in 78.2% of the patients (University of California at Los Angeles score equal or over 28). The patients' clinical results and postoperative arthrograms are evaluated with regard to the quality of cuff repair. Painful massive rotator cuff tears can be repaired in patients older than 70 years with satisfactory results.