Therefore, surgical treatment could be effective for older adults with symptomatic rotator cuff tears and failed conservative management, including those older than 75 years. Older people tend to suffer from larger rotator cuff tears.
Age alone can no longer be considered a barrier to rotator cuff repair. The fact is that patients are remaining active later into life and are living longer. Many patients in their 70s are very healthy and want to continue activities such as golf and tennis.
Moreover, 1 study exclusive to massive RCT in patients older than 70 years revealed a 78% satisfaction rate following repair, also based on UCLA scores of 28 or higher. Overall, the evidence has demonstrated that satisfactory results can be achieved through surgical repair of RCT in elderly patients.
Treatment can consist of various conservative therapies (including ice, simple exercises, medications), and progress to more intensive physical therapy and/or corticosteroid injections. Rotator cuff dysfunction is a common musculoskeletal disorder in elderly patients and is often underdiagnosed and undertreated.
Age. The risk of degenerative rotator cuff tears increases with age, becoming more common after age 35. However, people age 60 and over are more likely to develop degenerative rotator cuff injuries as the muscles succumb to repetitive use over time.
You may not need surgery if: Your shoulder gets better with physiotherapy. You have a torn rotator cuff but you are not in pain. You can do your daily activities.
Prolotherapy is effective for rotator cuff tears, labral tears and biceps tendonitis, various tendonitis as well as shoulder instability.
Typically tears occur in those over age 40, but occasionally tears are seen in younger individuals. Typical signs of a rotator cuff tear include pain with overhead use of the arm, weakness or pain preventing or disrupting sleep.
Even though most tears cannot heal on their own, you can often achieve good function without surgery. If, however, you are active or use your arm for overhead work or sports, surgery is most often recommended because many tears will not heal without surgery.
What is the success rate for rotator cuff surgery? Rotator cuff surgery has more than a 95% success rate for small tears. For two tendon tears, the success rate is still greater than 70%. Untreated tears tend to get bigger, so it is best to repair tears while they are small.
Even in elderly patients aged ≥ 75 years, high healing rate of a repaired RCT over 85% was shown in cases of small to medium tears. Although the retear rate was relatively high for large to massive tears, clinical outcomes were still significantly improved.
A rotator cuff surgery is a major surgical intervention in the shoulder, and the reason that there is pain after surgery is the amount of normal surgical trauma.
In general, surgery involving anesthesia, which includes rotator cuff surgery, poses a slight risk of stroke, heart attack, pneumonia, or blood clot. Damage to adjacent nerves and blood vessels. One study found that 1 to 2% of patients going through rotator cuff surgery experience nerve damage.
The reality of rotator cuff surgery is that while most tendons heal back to the bone after surgery, not all repaired tendons heal completely, and some do not heal at all. There are many reasons for this lack of healing with surgery.
Delaying treatment for a torn rotator cuff will increase your likelihood of developing further damage to your shoulder. When the tendons and muscles are torn and are not allowed to heal (usually due to overuse of the shoulder), they tend to fray over time.
Ultrasound does have the ability to identify rotator cuff tendon tears but with certain limitations. One factor is that it requires special training for the staff, as this is a less commonly performed imaging test. Second, the tendons may not be adequately seen in obese patients or those with a limited range of motion.
Rotator cuff tendon tears often cause pain at night. The pain may even wake you. During the day, the pain is more tolerable, and usually only hurts with certain movements, such as overhead or reaching toward the back. Over time, the symptoms become much worse and are not relieved by medicines, rest, or exercise.
Red flags include: Trauma, pain and weakness, or sudden loss of ability to actively raise the arm (with or without trauma): suspect acute rotator cuff tear. Any shoulder mass or swelling: suspect malignancy. Red skin, painful joint, fever, or the person is systemically unwell: suspect septic arthritis.
Keep moving. Staying active is important if you're waiting for surgery. That's because it can help to ease pain, it will make your muscles stronger and help your body to recover post-surgery. It will also improve your mobility, which can help with everyday movements around your home - from washing to getting dressed.
A partial or complete rotator cuff tear makes it difficult to raise and move your arm. You may have shoulder pain and arm weakness. Rotator cuff injuries are common, especially as you get older. Rest, pain relievers and physical therapy can help.
Nonsteroidal anti-inflammatory drugs (NSAIDs) Over-the-counter pain medications, such as ibuprofen, are used to ease discomfort by reducing the inflammation around the torn tendon. Strengthening and stretching exercises Physical therapy focuses on strengthening the muscles around the rotator cuff.
Massive rotator cuff tears involve tears in two complete tendons of the rotator cuff. A tear of more than 5 cm is described as massive. A massive tear may be associated with degeneration and retraction of the tendon and can be difficult to repair if treatment is delayed.
When only a small part of the tendon is detached from the bone, it is referred to as a full-thickness incomplete tear. When a tendon is completely detached from the bone, it is referred to as a full-thickness complete tear. With a full-thickness complete tear, there is basically a hole in the tendon.
What causes a rotator cuff injury? There are 2 main causes of rotator cuff tears: injury and degeneration. An injury to the rotator cuff, such as a tear, may happen suddenly when falling on an outstretched hand. It may also develop over time due to repetitive activities.