Clinical outcomes of arthroscopic superior capsule reconstruction in patients aged over 70 with irreparable rotator cuff tears.

ABSTRACT

Background: Arthroscopic superior capsule reconstruction (SCR) was developed to restore superior shoulder stability, muscle balance, and function after irreparable posterior-superior rotator cuff tears. The purpose of this study was to investigate whether favorable clinical outcomes after SCR for irreparable rotator cuff tears would be obtained in patients aged more than 70 years. Methods: A total of 173 consecutive shoulders in 162 patients who underwent arthroscopic SCR using autografts of fascia lata for irreparable rotator cuff tears were allocated to 3 groups according to patient age at the time of surgery Group 1, <55 years old (11 shoulders); Group 2, 55-70 years old (85 shoulders); and Group 3, > 70 years old (77 shoulders). American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores, active shoulder range of motion, and visual analog scale were evaluated before surgery and at the final follow-up. Postoperative complications, including graft tears in magnetic resonance imaging and donor-site morbidity, were assessed. Results: The mean follow-up was 3 years and 9 months. Both American Shoulder and Elbow Surgeons and Japanese Orthopaedic Association scores and active range of motion (elevation, external rotation, and internal rotation) increased significantly after arthroscopic SCR in all 3 groups (P < .001), and visual analog scale decreased significantly. All 3 groups had low graft tear (6%-10%) and donor site morbidity (0%-1%) rates, with no significant difference among the groups. Conclusion: Arthroscopic SCR can lead to functional improvement and pain relief with a low rate of complications regardless of patient age.