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  • Title: Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years' follow-up.
    Author: Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh I.
    Journal: Arthroscopy; 2003 Sep; 19(7):746-54. PubMed ID: 12966383.
    Abstract:
    PURPOSE: The purpose of this study was to compare the outcomes of arthroscopic repair of medium and large rotator cuff tears with the outcomes for mini-open repair of similar tears in which arthroscopic repair was technically unsuccessful. TYPE OF STUDY: Retrospective case series. METHODS: We evaluated 76 patients who were treated for full-thickness rotator cuff tears either by all-arthroscopic (42 patients) or mini-open salvage of technically unsuccessful arthroscopic repair (34 patients). Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 men and 37 women, with a mean age of 56 years (range, 42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared using the University of California Los Angeles and American Shoulder and Elbow Surgeons shoulder rating scales. RESULTS: Shoulder scores improved in all ratings in both groups (P <.05). Overall, 66 patients showed excellent or good and 10 patients showed fair or poor scores by the University of California Los Angeles scale. Seventy-two patients satisfactorily returned to previous activity, and 4 showed unsatisfactory returns. The range of motion, strength, and patient satisfaction were improved postoperatively. No differences were seen in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (P >.05). However, patients with larger tears showed lower shoulder scores and less predictable recovery of strength and function (P <.05). Postoperative pain was not different with respect to the size of the tear (P =.251). CONCLUSIONS: Arthroscopic repair of medium and large full-thickness rotator cuff tears had an equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini-open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.
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