Shoulder Surgery in the Elderly Reduces Pain

A new study shows that minimally invasive arthroscopic rotator cuff repair in patients aged 70 years or older can significantly reduce pain and improve function.

Researchers at Rush University Medical Center (Chicago, IL, USA) identified 44 consecutive patients aged 70 years or older undergoing primary all-arthroscopic repair of symptomatic full-thickness tears of the rotator cuff. A minimum 2-year follow-up was performed by an independent examiner--including range of motion and dynamometer strength testing--and shoulder functional outcome scores and pain score on a visual analog scale (VAS) were determined. Paired tests were performed to compare preoperative and postoperative measures, and postoperative scores were normalized with scores from age- and sex-matched healthy individuals.

The results showed that in the 39 (88.6%) patients available for follow-up evaluation, the American Shoulder and Elbow Surgeons score improved from a mean of 45.8 to a mean of 87.5 at final follow-up. The Simple Shoulder Test score improved from a mean 3.9 to a mean 9.8 score. The pain score on the VAS improved from 4.6 to 0.5, an improvement of 96%, and forward elevation increased from a mean 114.8 degrees to 146.2. Almost all of the patients reported improved function in their shoulder, and 94% said they were satisfied and would undergo the surgery again if they had to make the decision over again. The study was published early online on August 20, 2010, in Arthroscopy.

"In people over the age of 70, pain is the main issue, and pain relief is a fairly reliable outcome after surgery,” said lead author Nikhil Verma, M.D., of the department of orthopedic surgery. "Patients do not require that their shoulder function be fully restored. They just want the pain to be gone.”

The researchers added that when the postoperative results were viewed in light of the normal aging process, the majority of individuals had a shoulder that functioned nearly as well as a healthy shoulder for that age group and gender.

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Rush University Medical Center