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Elderly May Benefit From Minimally Invasive Shoulder Surgery

Posted Sep 08 2010 11:00am
Significant pain reduction reported by 96% after operation to repair rotator cuff tears, researchers find

By Robert Preidt
Wednesday, September 8, 2010
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WEDNESDAY, Sept. 8 (HealthDay News) -- Minimally invasive arthroscopic surgery to repair torn shoulder muscles in elderly people can reduce pain and improve function, a new study finds.

Many doctors are reluctant to perform this type of surgery in older patients because of fears of complications. But the researchers at Rush University Medical Center in Chicago said their findings show that seniors shouldn't be excluded from having this surgery.

About 20 percent of people older than 65 suffer tears in the rotator cuff, the group of four muscles and their tendons that form a "cuff" over the top of the upper arm bone and stabilize the back of the shoulder joint. These tears can cause considerable pain and loss of range of motion.

"In people over the age of 70, pain is the main issue, and pain relief is a fairly reliable outcome after surgery," said study leader and orthopedic surgeon Dr. Nikhil Verma. "Patients do not require that their shoulder function be fully restored. They just want the pain to be gone." Verma is assistant professor of orthopedic surgery at Rush.

With that requirement, Verma said, "age is not a contraindication" for the surgery.

This study included 39 patients over age 70 who underwent surgery to repair rotator cuff tears after pain medication and other treatments failed to help them. The patients were followed for two years after their surgery.

Significant pain reduction was reported by 96 percent of patients, and there were major improvements in shoulder function, range of arm motion and muscle strength, the study found.

Following the surgery, shoulder function was nearly the same as what could be expected in a healthy shoulder for people in this age group, the researchers noted.

The study appears online and in the October print issue of Arthroscopy: The Journal of Arthroscopic and Related Surgery.

The American Academy of Orthopaedic Surgeons (AAOS) notes that that the best treatment varies from patient to patient. Non-surgical alternatives to conventional and arthroscopic rotator cuff surgery, according to the AAOS, include the use of a sling; rest and avoiding activities that cause symptoms; anti-inflammatory medications or steroid injections; and strength-building exercises and physical therapy.

The AAOS also cautions that -- like any operation -- the surgery is not without risk. Possible side effects, according to the academy, include infection, difficulty moving the shoulder after the operation and a re-tear requiring another surgery.

SOURCE: "Rotator Cuff Tears and Treatment Options," American Academy of Orthopaedic Surgeons, 2010; Cochrane Database of Systematic Reviews, 2010; Rush University Medical Center, news release, Sept. 1, 2010.


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