Rotator Cuff Surgery in Patients over 60: All is not Roses
Do patients over 60 have the same rotator cuff surgery recovery? We often believe that getting surgery is like taking your car into get repaired-all potential upside with no downside. However, many studies have shown significant complication rates for common joint surgeries such as knee replacement and hip replacement. A recent study looked at a very commonly operated group, patients who are over 60 with a shoulder rotator cuff tear.The results? About 8% of patients had a complications, consistent with other studies that show the rate of side effects from shoulder surgery to be a bit less than 1 in 10. What was surprising is that the rate of healing in the rotator cuff tears treated with surgery was only 2 in 3, meaning 1 in 3 didn’t heal despite surgery. This is an important number as it means a healthy percentage of patients over 60 don’t heal their tear despite shoulder surgery and 6 weeks spent walking around in a shoulder immobilizer. Why wouldn’t all the shoulder rotator cuff tears heal? One of the reasons rotator cuff muscles and or tendons tear in middle aged and elderly patients is because of poor blood supply. So since the surgery does nothing to improve this poor blood supply, many of these rotator cuff tears likely struggle to heal, as a poor blood supply means poor healing. This may be an advantage for newer types of cellular based therapies delivered through a needle versus through surgery, as many of these cell types (platelets for PRP and certain stem cells) are known to work by bringing in new blood supply. The upshot? If you’re over 60, getting your shoulder rotator cuff tear surgically repaired doesn’t guarantee it will heal, in fact many patients don’t experience healing despite the big surgical risks and downtime associated with the procedure.