Similar Clinical and Patient Recorded Outcomes Amongst Older Patients over 65 Years of Age Compared to Younger Patients undergoing Arthroscopic Rotator Cuff Repair
Recommended Citation
Castle J, Jiang E, Wager S, Brown S, Kasto J, Gasparro M, Muh S, Makhni E, Moutzouros V, Gaudiani M. Similar Clinical and Patient Recorded Outcomes Amongst Older Patients over 65 Years of Age Compared to Younger Patients undergoing Arthroscopic Rotator Cuff Repair. 2023; (7).
Document Type
Conference Proceeding
Publication Date
7-31-2023
Abstract
Objectives: The purpose of our study was to determine if patients 65 years and over meet the minimally clinical important difference (MCID) for Patient-Reported Outcomes Measurement Information System Upper Extremity (PROMIS-UE), Depression (PROMIS-D), and Pain Interference (PROMIS-PI) at similar rates compared to a cohort of younger patients. Methods: A retrospective review of a prospectively collected database of patients undergoing RCR was performed. Patients with completed preoperative and 6-month follow up postoperative PROMIS scores were included. A cohort of 65 years and older (65<) was compared to a cohort of 64 years and younger (64>=) in terms of their clinical outcomes and PROMIS scores. A propensity matched analysis was then performed, which matched patients 65+ years old 1:1 to a cohort of 50 years or younger via tear size and body mass index (BMI). Results: A total of 318 patients were included with 79 patients ≥ 65 years (69.2 ± 3.4 years, mean ± SD) and 239 patients <65 years (55.1 ± 3.4 years). No significant differences were found in terms of gender, tear thickness, tear size, reoperation rate, retear rate, preoperative PROMIS-UE, PROMIS-PI, and PROMIS D scores, or change in postoperative PROMIS-UE, PROMIS-PI, and PROMIS D after 6 months. In the sub-analysis, 44 patients over 65 years of age were propensity matched to 44 under 50 years of age. No differences were found in PROMIS-UE change, PROMISD change, proportion meeting MCID PROMIS UE, and proportion meeting MCID of PROMIS PI after 6 months. Patients in the 65+ years group experienced larger changes in PROMIS PI scores (12.5 ± 9.6 vs 7.2 ± 7.5, p=0.005) while fewer patients experienced significant declines in PROMIS D scores (26% vs 47%, p=0.03). Conclusions: Patients ≥ 65 years experience no differences in reoperation or retear rate when compared to younger patients. Older patients undergoing RCR were more likely to have a larger improvement in pain scores but were less likely to have significant clinical change in their depression scores. With proper patient selection, patients ≥ 65 years can achieve clinically significant improvements 6 months after RCR that is similar to their younger counterparts.
PubMed ID
Not assigned.
Issue
7