By Jill Stein
SAN DIEGO -- March 20, 2017 -- The re-tear rate after rotator cuff repair (RCR) surgery increases at different rates as patient age increases, according to results of a retrospective cohort study reported at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
The exact mechanism by which age leads to re-tear has not been clearly established, noted lead author Georgia Diebold, medical student, University of New South Wales Port Macquarie Rural Clinical School, Port Macquarie, Australia, speaking here at a poster presentation on March 15. There is some evidence to suggest that loss of structural organisation in collagen in the tendon occurs as patient age increases, leading to decreased tendon integrity and a higher chance of re-tear after surgery, she noted.
Diebold and colleagues from St. George Hospital Campus, Sydney, Australia, reviewed prospectively collected data in patients who had undergone RCR surgery at their centre by a single surgeon between August 2005 and December 2014. Using ultrasound, the team aimed to determine the relationship between patient age and the integrity of RCR at the 6-month follow-up visit.
Overall, 1,388 intact RCRs and 212 re-tears were identified on ultrasound at the 6-month follow-up examination, for an overall re-tear rate of 13%.
Preoperative tear size and patient age at the time of surgery were the strongest independent predictors for re-tear.
Patients who experienced a re-tear were about 7 years older than patients whose RCR was intact at follow up.
In patients under 50 years of age, the re-tear rate was low (5%), and changed minimally with age. In patients aged 50 to 70 years, the re-tear rate increased linearly by 5% each decade.
The largest increase in re-tear rate occurred in patients aged 60 to 69 years and those aged 70 to 79 years (P = .001). The odds ratio between these 2 groups was 1.89, meaning that patients 70 to 79 years of age were almost twice as likely to re-tear as patients 60 to 69 years of age.
All subjects followed a 6-month postoperative rehabilitation programme.
Re-tear is the most common complication after surgical RCR, with recent studies suggesting that the re-tear rate varies between 9% and 36%, the investigators observed.
[Presentation title: The Relationship between Age and Rotator Cuff Retear. Abstract P328]
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