Rotator cuff tears in young patients: a different disease than rotator cuff tears in elderly patients

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• 作者：Alexander L. Lazarides ; BSc^a ; Eduard Alentorn-Geli ; MD ; MSc ; PhD ; FEBOT^b ; J.H. James Choi ; MD^b ; Joseph J. Stuart ; MD^b ; Ian K.Y. Lo ; MD^c ; Grant E. Garrigues ; MD^b ; Col. (ret) Dean C. Taylor ; MD^b ; ^{dean.taylor@dm.duke.edu" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Level IV ; Systematic Review
• 刊名：Journal of Shoulder and Elbow Surgery
• 出版年：2015
• 出版时间：November 2015
• 年：2015
• 卷：24
• 期：11
• 页码：1834-1843
• 全文大小：223 K

文摘

The purpose of this study was to conduct a systematic review of the literature to evaluate the characteristics of injury and treatment outcomes of rotator cuff tears in young patients.

Methods

A systematic electronic search was performed for clinical studies evaluating rotator cuff tears in patients younger than 40 years with special emphasis on reporting of injury characteristics and treatment outcomes with a minimum 1-year follow-up.

Results

Twelve studies (involving 336 patients) met inclusion criteria. The mean age of the patients was 28 years (range, 16-40 years), with a mean follow-up of 39 months. There were 2 distinct subgroups. The majority of studies (7 of 10) showed that patients typically had a full-thickness tear with an acute traumatic etiology. However, within the subgroup of elite throwers, 5 of 6 studies demonstrated a majority of tears that were partial thickness stemming from chronic overuse. Rotator cuff repair improved pain and strength in almost all studies reporting on these parameters. Eighty-seven percent of patients reported they were satisfied. However, all studies examining elite throwers showed significant difficulty in returning to play (25%-97%).

Conclusions

In young patients with rotator cuff tears, there are 2 primary groups. (1) A majority group with rotator cuff tears of traumatic origin responded well to both arthroscopic and open rotator cuff repair in terms of pain relief and self-reported outcomes postoperatively. These patients reported high levels of satisfaction and return to preinjury level of play. (2) A unique subpopulation composed of elite throwers had improved outcomes but suboptimal return to play.