Purpose: With this retrospective study, the results of rotator cuff repairs in patients of 60 years and older were compared to patients younger 60.

Methods: 76 patients with an average age of 65 years (60–78 years, group A) and 167 patients younger 60 years (group B) were clinical (Constant – score) and sonographical examined after follow-up of 2 years after reconstruction of the rotator cuff.

Results: In group A, 24 one-, 37 two-, 11 three- and 4 four-tendon tears were treated and the average age and gender adjusted Constant-score was 90,4% (13–126%). 29% showed sonographical signs of a re-defect. In group B, 56 one-, 69 two-, 33 three-, and 9 four-tendon tears were treated and the average age and gender adjusted Constant-score was 81,1% (15–116%). 32% showed sonographical signs of a re-defect.

Conclusion: Both groups did not show significant differences regarding clinical results in the Constant-score size of the rotator cuff defect or occurrence of re-tears. The results in patients older 60 were even better than in younger patients, therefore the older age of the patient should not be primary reason for not repairing a symptomatic rotator cuff tear.

Purpose: In this retrospective study we have analysed the effect of retears and muscle-malfunction on the results of the repair of 90 massive rotator cuff tears (MRCT) with a minimum follow-up of 2 years.

Materials: We reviewed 90 patients (15F,75M) with 90 massive rotator cuff tear repairs (66R, 24L). The age at surgery was 59 (45–75) years, follow-up 49 (24–134) months. 53 patients had a direct repair and transosseus fixation, 33 patients a local tendon transfer, and 4 a delta-flap. Beside clinical assessement, and evaluation of the Constant-Score, a standarised dynamic and static ultrasound examination of the rotator cuff, SSP and ISP with their kinematic contraction patterns, was performed.

Results: 51.1% rated their result as excellent, 28.9% as good, 11.1% as moderate, 5.6% as fair and 3.3% as poor. The unadapted Constant-score was 68.5 (contralateral 75.8). 61.1% had an ultrasonographically intact cuff reconstruction, 27.8% had a small retear and 12.2% had a retear > 2cm. The Constant-score of patients with an intact reconstruction was 71.6, with large retears 59.7 and with small retears 64.3. Patients with normal Type I contraction patterns of SSP and ISP had a Constant-score of 78.3 and 74.8, whereas those with a type III (little contraction) had 54.9 and 53.1.

Conclusions: 80% good and excellent subjective results show an appropriate treatment of MRCT’s. Because of the significant influence (p< 0,03) of muscle-malfunction, a preoperative ultrasonography of the rotator cuff muscles is performed to assess the muscle function and determine the indication for a muscle transfer.