Prognostic Factors (Age)
Strong evidence supports that older age is associated with higher failure rates and poorer patient reported outcomes after rotator cuff repair.
Management of Rotator Cuff Injuries
Endorsed by: AANA, ASES, AOSSM, ASSET, APTA

Rationale
Three high quality studies (Deniz 2014, Park 2015, Rashid 2017) demonstrated higher re-tear rates are associated with advanced age.    Four high quality studies (Chung 2012, Deniz 2014, Kim 2016, Robinson 2013) demonstrated worse patient reported outcomes in patients with older age.

Risks and Harms of Implementing this Recommendation
While older age is associated with higher failure rates and poorer patient reported outcomes, age alone should not be used as a contraindication for rotator cuff repair, as failure to heal is related to multiple features.  Older patients should be counseled that they would be at increased risk for failure and poorer outcomes than younger patients who undergo rotator cuff repair.

Future Research
Degenerative rotator cuff disease is a phenomenon of aging, yet there is great variability in this phenomenon.  Future research is needed to distinguish chronological age from physiologic age, and healing will likely improve when age related changes to the rotator cuff are better understood and manipulated.

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