Age as a risk factor for Rotator Cuff Repair

Increasing patient age has been identified as a potential factor influencing outcomes and healing after rotator cuff surgery. Healing and strength (as indirectly measured by the Constant-Murley score) are critical factors in evaluating surgical success. Several studies determined that the Constant-Murley score (as a measure of shoulder strength) was negatively correlated with increasing age after rotator cuff repair.^{75, 51, 47, 54, 76} Similarly, numerous authors concluded that age was a negative predictor of posterosuperior rotator cuff healing after repair.^77-79

Age has also been shown to correlate with subjective outcomes after rotator cuff repair although the associations are not as strong as those for healing and strength. A number of studies have found increasing age to be negatively associated with clinical outcomes after rotator cuff surgery.^{47, 76, 80, 79, 51, 77, 75, 81, 82, 83} However, some studies found no effect of increasing age on clinical outcomes^{49, 72, 73, 84, 85, 86, 87, 88, 89, 90-92, 93}

Out of all 23 studies included, one author reported a negative correlation between increasing age and a patient-reported outcome measure.⁸¹ This study reported on 80 patients at 2 years after rotator cuff repair and concluded that older age was associated with worse DASH scores. The authors did perform a multivariate analysis confirming the relationship; therefore, this should be recognized as a significant finding. One other author⁸² reported VAS pain and reported age ranges for comparison groups. The findings are statistically significant but the authors do not define the size or direction of the effect. A third author reported “Treatment Response”, but this outcome is a composite of pain and internal/external rotation. It is therefore a composite of a patient-oriented outcome and a surrogate measure making it difficult to interpret.