The Analysis and Treatment of Rotator Cuff Tear After Shoulder Dislocation in Middle-Aged and Elderly Patients

ABSTRACT

PURPOSE: To evaluate clinical features and surgical results for rotator cuff tear secondary to shoulder dislocation in middle-aged and elderly patients. MATERIALS AND METHODS: We reviewed 19 patients over 50 years of age who had rotator cuff tears combined with shoulder dislocation between October 2004 and October 2008. There were 7 males and 12 females with a mean age 64.7 years (range, 50 to 78 years). The average follow-up duration was 22 months (range, 8 to 56 months). We investigated the number of dislocations, the size of the cuff tear, the presence of Bankart lesions and the time interval from dislocation to surgery. We also investigated the ASES score, UCLA score, SST score, and shoulder range of motion before and after surgery. We analyzed clinical outcomes and contributing factors. RESULTS: ASES scores improved from 30.2 preoperatively to 72.3 postoperatively; UCLA scores improved from 12.9 to 26.5; SST scores improved from 2.4 to 7.3. Range of motion improved significantly forward flexion, abduction, external rotation and internal rotation were, respectively, 110.8(+/-39.3)degrees, 107.7(+/-40)degrees, 22.5(+/-17.6)degrees and L5 level preoperatively; postoperatively they were 153.6(+/-20.6)degrees, 152.1(+/-20.8)degrees, 36.4(+/-22.7)degrees and L1 level. Age, the presence of Bankart lesions and the number of dislocations were not correlated with clinical outcomes. But the size of the cuff tear was correlated with clinical results. Also, the duration from dislocation to surgery was correlated with postoperative UCLA and SST scores (p=0.039, p=0.038). CONCLUSION: For shoulder dislocation, it is important to achieve early diagnoses of rotator cuff tears in middle-aged and elderly patients. If these injuries are both present, early rotator cuff repair should be performed for better clinical results.