Department of Orthopaedic Surgery, Seoul National University Hospital, 28 Yeongeon-dong, Jongno-gu, Seoul 110-744 Korea.
Am J Sports Med. 2010 Apr;38(4):672-8. doi: 10.1177/0363546509352460.
There are numerous reports on the outcome of rotator cuff repair according to age. However, the results are conflicting and driven by univariate analysis, which is not free of confounding factors.
Age does not affect the anatomical and functional outcomes of rotator cuff repair.
Case series; Level of evidence, 4.
Eighty-one men and 96 women underwent rotator cuff repair at one institution and received computed tomography arthrography and functional evaluations at least 1 year after surgery. Various structural and clinical features according to age were evaluated. The correlation was assessed between age and outcomes, with adjustment for the preoperative score.
Patient mean age was 60.0 +/- 8.7 years. The mean ages were higher in women, nonsmokers, and those with positive paradoxical abduction, lower level of sports activity, the presence of biceps injury, higher fatty degeneration in cuff muscles, inferior isokinetic muscle performance, bigger tear size, more retraction of tear, and symptomatic acromioclavicular arthritis. For the integrity of the repair, the mean age was higher in the retear group (31.1%) than in the intact group (68.9%)-that is, 63.7 +/- 7.5 and 58.4 +/- 8.7 years, respectively (P <.001). Only the Constant score exhibited a positive correlation with age after adjustment (P = .009). Univariate regression analysis revealed that a 0.313-point increment of Constant score could be expected for each year of age.
On univariate analysis, older age was related with poor postoperative integrity and better functional improvement in Constant score. Multivariate regression revealed that age was not an independent determinant for anatomical or functional outcome whereas the tear retraction and fatty degeneration of the infraspinatus were independent factors for the integrity of repair and the presence of the paradoxical abduction and abduction torque of the unaffected shoulder for the Constant score.
有大量关于肩袖修复结果的年龄报告。然而，这些结果存在冲突，并且受到单变量分析的驱动，而单变量分析并非没有混杂因素。
年龄不会影响肩袖修复的解剖和功能结果。
病例系列；证据水平，4 级。
在一家机构接受肩袖修复的 81 名男性和 96 名女性，术后至少 1 年接受计算机断层扫描关节造影和功能评估。根据年龄评估各种结构和临床特征。评估年龄与结果之间的相关性，并根据术前评分进行调整。
患者平均年龄为 60.0±8.7 岁。女性、不吸烟者、阳性反常外展、较低的运动水平、肱二头肌损伤、肩袖肌肉脂肪变性程度较高、等速肌肉性能较差、撕裂较大、撕裂回缩较大以及症状性肩锁关节炎的患者年龄较高。在肩袖修复的完整性方面，再撕裂组（31.1%）的平均年龄高于完整组（68.9%），分别为 63.7±7.5 岁和 58.4±8.7 岁（P<.001）。只有常数评分在调整后与年龄呈正相关（P=.009）。单变量回归分析显示，常数评分每增加 0.313 分，年龄就会增加 1 岁。
在单变量分析中，年龄与术后完整性较差和 Constant 评分功能改善较好相关。多变量回归显示，年龄不是解剖或功能结果的独立决定因素，而撕裂回缩和冈下肌脂肪变性是修复完整性的独立因素，反常外展和未受影响肩部的外展扭矩是 Constant 评分的独立因素。
