Unit of Arthroscopy and Sports Trauma Surgery, Hesperia Hospital, Via Arquà 80/b, Modena, Italy.
Knee Surg Sports Traumatol Arthrosc. 2010 Dec;18(12):1700-6. doi: 10.1007/s00167-010-1081-9. Epub 2010 Feb 25.
We compared the outcomes of arthroscopically repaired rotator cuff tears in 28 patients older than 65 years (the over 65 group: median age 70 years) with a control group of 28 patients younger than 65 years (the under 65 group: median age 57 years). The groups were similar in regard to sex distribution, surgical technique, and post-operative rehabilitation programmes, but different in age. After careful arthroscopic evaluation of the full-thickness rotator cuff tear, rotator cuff repair and biceps tenotomy were performed in all patients. Pre- and post-operatively, each patient was evaluated for range of motion, shoulder score (UCLA), and SF-36 self-administered questionnaire. Comparing pre- versus post-operative status at a minimum 24 months follow-up, forward elevation, internal and external rotation, modified UCLA rating system scores, and SF-36 scores improved significantly in both groups, with no significant difference between the groups. At the last follow-up, strength improved significantly in both groups, with non-significant intergroup difference. The Popeye sign was detected in 13/28 (46%) of the patients in the over 65 group and in 11/28 (39%) in the under 65 group (χ = 0.29) with non-significant difference between the two groups. In selected active patients older than 65, arthroscopic rotator cuff repair associated with biceps tenotomy (when necessary) can yield clinical and related quality of life outcomes similar to those of patients younger than 65 years.
我们比较了 28 例年龄大于 65 岁（65 岁以上组：中位年龄 70 岁）的关节镜修复肩袖撕裂患者和 28 例年龄小于 65 岁的对照组患者（65 岁以下组：中位年龄 57 岁）的治疗结果。两组在性别分布、手术技术和术后康复方案方面相似，但在年龄方面存在差异。所有患者均行关节镜全面评估全层肩袖撕裂后，行肩袖修复和肱二头肌切断术。术前和术后，每位患者均进行了运动范围、肩部评分（UCLA）和 SF-36 自我管理问卷评估。在至少 24 个月的随访中，与术前相比，两组患者的外展、内旋和外旋、改良 UCLA 评分系统评分和 SF-36 评分均显著改善，两组间无显著差异。末次随访时，两组患者的肌力均显著改善，两组间无显著差异。65 岁以上组 28 例患者中有 13 例（46%）和 65 岁以下组 28 例患者中有 11 例（39%）出现 Popeye 征（χ = 0.29），两组间无显著差异。在选择的 65 岁以上活跃患者中，关节镜肩袖修复联合肱二头肌切断术（必要时）可获得与 65 岁以下患者相似的临床和相关生活质量结果。
