Editorial Commentary: Repair Is Efficacious for Acute Rotator Cuff Tears in Patients Over 65 Despite Advanced Age, and Early Repair Is Better.

Although indications for rotator cuff repair are still controversial, common practice is to be more aggressive with surgery as a first-line treatment in patients with acute rotator cuff tears. Both functional outcomes and healing are better with earlier repair, and a healed tendon limits the progression of permanent degenerative changes, including tear progression, fatty infiltration, and progression to cuff tear arthropathy. But what about elderly patients? For those that are physically and medically fit for surgery, there may still be benefit to earlier surgical repair. For those not physically or medically fit for surgery, or those who decline, a short trial of conservative care and repair for those who fail with conservative treatment is still efficacious.