Surgical treatment of full-thickness rotator cuff tears in patients 40 years of age or younger

Full-thickness tears of the rotator cuff are uncommon in the first 4 decades of life. A retrospective analysis was conducted of 19 consecutive patients who were 40 years of age or younger and had been treated surgically for a full-thickness tear of the rotator cuff. Sixteen patients (84%) recalled an acute injury that heralded the onset of symptoms. Five of the patients had sustained an initial glenohumeral dislocation. At an average follow-up of 5.7 years, all patients were evaluated with regard to pain, function, range of motion, strength, return-to-work status, return-to-sport status, and overall postoperative satisfaction. After operation, 15 patients (79%) reported diminished pain relative to their preoperative level, and 12 (63%) of 19 were able to function with the extremity above shoulder level. Fourteen patients (74%) returned to full-time employment, and half returned to sporting activities. Thirteen patients (68%) reported subjective improvement with regard to daily functional activities after surgical intervention. The most favorable results were seen in those patients who had sustained an acute glenohumeral dislocation in conjunction with a full-thickness rotator cuff tear and underwent combined stabilization and repair. The outcome for patients who received workerʹs compensation was less favorable.