Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Via Mangiagalli 31, 20133, Milan, Italy.
U.O.C. 1a Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Piazza Cardinal Ferrari 1, 20122, Milan, Italy.
J Orthop Traumatol. 2021 Feb 18;22(1):3. doi: 10.1186/s10195-021-00565-z.
Failure of conservative treatment in patients over 70 years of age with a rotator cuff tear makes surgery a possible option, considering the increase in life expectancy and the high functional demands of elderly patients. The purpose of this systematic review of the literature was to evaluate the subjective and objective outcomes after arthroscopic rotator cuff repair in patients over 70 years of age.
A systematic review was performed to identify all the studies reporting subjective and objective outcomes in patients aged 70 years or older undergoing arthroscopic rotator cuff repair. Constant Murley Score (CMS), visual analog scale (VAS), American Shoulder and Elbow Surgeons Score (ASES), and Simple Shoulder Test (SST) were used to detect any clinical improvement after surgery. Retear and satisfaction were also analyzed.
Out of 941 studies identified, only 6 papers have been included in the review. All studies reported improvements in postoperative functional outcome scores that exceed the minimal clinically relevant difference. The mean retear rate amounts to 21.9%, which is in line with the failure rate of rotator cuff repair in general population. Moreover, postoperative satisfaction is very high (95%).
This systematic review suggests that arthroscopic rotator cuff repair in patients over 70 years of age could be a valid treatment option after failure of conservative approach.
4 Trial registration The study was registered on PROSPERO (registration ID: CRD42018088613).
对于 70 岁以上的肩袖撕裂患者，若保守治疗失败，考虑到预期寿命的延长和老年患者对功能的高要求，手术可能是一种选择。本系统文献回顾的目的是评估 70 岁以上患者行关节镜肩袖修复术后的主观和客观疗效。
系统检索所有报道 70 岁及以上患者行关节镜肩袖修复术后主观和客观疗效的研究。采用 Constant-Murley 评分（CMS）、视觉模拟评分（VAS）、美国肩肘外科医生评分（ASES）和简易肩功能测试（SST）来检测术后的临床改善情况。同时分析肩袖再撕裂和满意度。
在 941 项研究中，仅有 6 篇文献被纳入本综述。所有研究均报告术后功能评分的改善超过了最小临床相关差异。总的再撕裂率为 21.9%，与一般人群肩袖修复的失败率相当。此外，术后满意度非常高（95%）。
本系统综述表明，对于保守治疗失败的 70 岁以上患者，关节镜肩袖修复术可能是一种有效的治疗选择。
4 级。 研究注册：本研究在 PROSPERO 上进行了注册（注册号：CRD42018088613）。
