# Excellent functional outcomes in patients aged 40 years or older undergoing isolated rotator cuff repair for rotator cuff tears after primary traumatic anteroinferior shoulder dislocation

## TL;DR

Older patients who had rotator cuff surgery after a shoulder dislocation had good recovery and no re-dislocations.

## Contribution

Shows that isolated rotator cuff repair in older patients after shoulder dislocation yields excellent functional outcomes.

## Key findings

- Functional outcomes were comparable between instability-related and non-instability-related rotator cuff tear patients.
- No re-dislocations occurred in patients after isolated rotator cuff repair.
- Range of motion and patient-reported scores were similar between groups.

## Abstract

To investigate the functional outcomes of patients over 40 years of age who underwent isolated rotator cuff (RC) repair (RCR) for full-thickness RC tears resulting from a primary traumatic anteroinferior shoulder dislocation and to compare these outcomes with a control group of patients who underwent RCR for instability-independent RC tears, with a minimum follow-up of two years.

Patients aged 40 years and older were included for RCR following primary traumatic anteroinferior shoulder dislocation between 01/2012 and 06/2020 with a minimum follow-up of two years. Patients were excluded if they received an additional labral repair or capsular shift. Outcomes were compared to a control group of patients who underwent RCR without history of previous dislocations. Primary outcome measures included passive range of motion (ROM) as well as patient reported outcomes comprising the Western Ontario Shoulder Instability Index (WOSI) and Rowe score. Rates of re-dislocation were evaluated as secondary outcomes.

Thirty-six patients were enrolled and divided into 2 groups (n = 18, respectively). Demographic characteristics did not significantly differ (p > 0.05). At final follow-up, patients affected by instability-related RC tears showed comparable functional outcomes in terms of WOSI (427.2 ± 238.9instability group (IG) vs. 431.1 ± 252.1control group (CG); p = 0.962) and Rowe (87.5 ± 12.0IG vs. 91.1 ± 10.2CG; p = 0.339) scores as well as in terms of passive ROM (abduction: 88.1 ± 4.6°IG vs. 86.7 ± 11.5°CG; p = 0.637, forward elevation: 87.8 ± 6.2°IG vs. 88.3 ± 5.1°CG; p = 0.772, external rotation: 55.3 ± 10.5°IG vs. 50.8 ± 15.3°CG; p = 0.312, internal rotation: 65.3 ± 8.5IG vs. 68.8 ± 4.9CG, p = 0.388). No patient experienced a re-dislocation.

Patients ≥ 40 years who underwent isolated RCR without labral repair or capsular shift for a concurrent RC tear after experiencing a primary traumatic anteroinferior shoulder dislocation, achieved favorable functional outcomes along with absence of re-dislocations.

Retrospective case series; Level of Evidence IV.