Top

Journal of Orthopaedic Surgery and Research

Published in:

Open Access 01-12-2007 | Research article

The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up

Authors: Albert W Pearsall IV, Khalid A Ibrahim, Sudhakar G Madanagopal

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2007

Abstract

Background

To prospectively evaluate patients who underwent a "mini-open" repair versus a completely arthroscopic technique for small to large size rotator cuff tears.

Methods

Fifty-two patients underwent "mini-open" or all arthroscopic repair of a full thickness tear of the rotator cuff. Patients who complained of shoulder pain and/or weakness and who had failed a minimum of 6 weeks of physical therapy and had at least one sub-acromial injection were surgical candidates. Pre and post-operative clinical evaluations included the following: 1) demographics; 2) Simple Shoulder Test (SST); 3) University of California, Los Angeles (UCLA) rating scale; 4) visual analog pain assessment (VAS); and 5) pre-op SF12 assessment. Descriptive analysis was performed for patient demographics and for all variables. Pre and post outcome scores, range of motion and pain scale were compared using paired t-tests. Analysis of variance (ANOVA) was used to evaluate any effect between dependent and independent variables. Significance was set at p is less than or equal to 0.05.

Results

There were 31 females and 21 males. The average follow-up was 50.6 months (27 – 84 months). The average age was similar between the two groups [arthroscopic x = 55 years/mini-open x = 58 years, p = 0.7]. Twenty-seven patients underwent arthroscopic repair and 25 underwent repair with a mini-open incision. The average rotator cuff tear size was 3.1 cm (range: 1–5 centimeters). There was no significant difference in tear size between the two groups (arthroscopic group = 2.9 cm/mini-open group = 3.2 cm, p = 0.3). Overall, there was a significant improvement from pre-operative status in shoulder pain, shoulder function as measured on the Simple Shoulder test and UCLA Shoulder Form. Visual analog pain improved, on average, 4.4 points and the most recent Short Shoulder Form and UCLA scores were 8 and 26 respectively. Both active and passive glenohumeral joint range of motion improved significantly from pre-operatively.

Conclusion

Based upon the number available, we found no statistical difference in outcome between the two groups, indicating that either procedure is efficacious in the treatment of small and medium size rotator cuff tears.

Level of Evidence

Type III

DePalma AF, Callery G, Bennett GA: Variational anatomy and degenerative lesions of the shoulder joint. Instr Course Lect. 1949, 6: 255-281.

Codman EA: The Shoulder; Rupture of the Supraspinatus Tendon and Other Lesions in or About the Subacromial Bursa. Boston: Thomas Todd. 1934

Hijioka A, Suzuki K, Nakamura T, Hojo T: Degenerative change and rotator cuff tears. An anatomical study in 160 shoulders of 80 cadavers. Arch Orthop Trauma Surg. 1993, 112(2): 61-64. 10.1007/BF00420255.

Jerosch J, Muller T, Castro WH: The incidence of rotator cuff rupture. An anatomic study. Acta Orthop Belg. 1991, 57(2): 124-129.

Keyes EL: Anatomical observations on senile changes in the shoulder. J Bone Joint Surg. 1935, 17: 953-960.

Cotton RE, Rideout DF: TEARS OF THE HUMERAL ROTATOR CUFF; A RADIOLOGICAL AND PATHOLOGICAL NECROPSY SURVEY. J Bone Joint Surg Br. 1964, 46: 314-328.PubMed

Gerber C, Fuchs B, Hodler J: The results of repair of massive tears of the rotator cuff. J Bone Joint Surg Am. 2000, 82(4): 505-515.

Gazielly DF, Gleyze P, Montagnon C: Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res. 1994, 304: 43-53.PubMed

Adamson GF, Tibone JE: Ten year assessment of primary rotator cuff repairs. J Shoulder Elbow Surg. 1993, 2: 57-63.PubMed

10.

Ogilvie-Harris DJ, Demaziere A: Arthroscopic debridement versus open repair for rotator cuff tears. A prospective cohort study. J Bone Joint Surg Br. 1993, 75 (3): 416-420.PubMed

11.

Galatz LM, Griggs S, Cameron BD, Iannotti JP: Prospective longitudinal analysis of postoperative shoulder function: a ten-year follow-up study of full-thickness rotator cuff tears. J Bone Joint Surg Am. 2001, 83-A (7): 1052-1056.PubMed

12.

Harryman DT, Mack LA, Wang KY, Jackins SE, Richardson ML, Matsen FA: Repairs of the rotator cuff. Correlation of functional results with integrity of the cuff. J Bone Joint Surg Am. 1991, 73 (7): 982-989.PubMed

13.

Bigliani LU, Cordasco FA, McIlveen SJ, Muso ES: Operative repairs of massive rotator cuff tears: long-term results. J Shoulder Elbow Surg. 1992, 1: 120-130.PubMed

14.

Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM: Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am. 2001, 83-A (1): 71-77.PubMed

15.

Ellman H, Hanker G, Bayer M: Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am. 1986, 68 (8): 1136-1144.PubMed

16.

Hawkins RJ, Misamore GW, Hobeika PE: Surgery for full-thickness rotator-cuff tears. J Bone Joint Surg Am. 1985, 67 (9): 1349-1355.PubMed

17.

Misamore GW, Ziegler DW, Rushton JL: Repair of the rotator cuff. A comparison of results in two populations of patients. J Bone Joint Surg Am. 1995, 77 (9): 1335-1339.PubMed

18.

Hawkins RJ, Morin WD, Bonutti PM: Surgical treatment of full-thickness rotator cuff tears in patients 40 years of age or younger. J Shoulder Elbow Surg. 1999, 8 (3): 259-265. 10.1016/S1058-2746(99)90139-8.PubMed

19.

Grondel RJ, Savoie FH, Field LD: Rotator cuff repairs in patients 62 years of age or older. J Shoulder Elbow Surg. 2001, 10 (2): 97-99. 10.1067/mse.2001.110513.PubMed

20.

Pai VS, Lawson DA: Rotator cuff repair in a district hospital setting: outcomes and analysis of prognostic factors. J Shoulder Elbow Surg. 2001, 10 (3): 236-241. 10.1067/mse.2001.113963.PubMed

21.

Watson EM, Sonnabend DH: Outcome of rotator cuff repair. J Shoulder Elbow Surg. 2002, 11 (3): 201-211. 10.1067/mse.2002.122271.PubMed

22.

Bassett RW, Cofield RH: Acute tears of the rotator cuff. The timing of surgical repair. Clin Orthop Relat Res. 1983, 175: 18-24.PubMed

23.

Levy HJ, Uribe JW, Delaney LG: Arthroscopic assisted rotator cuff repair: preliminary results. Arthroscopy. 1990, 6 (1): 55-60.PubMed

24.

Liu SH, Baker CL: Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994, 10 (1): 54-60.PubMed

25.

Paulos LE, Kody MH: Arthroscopically enhanced "miniapproach" to rotator cuff repair. Am J Sports Med. 1994, 22 (1): 19-25. 10.1177/036354659402200104.PubMed

26.

Blevins FT, Warren RF, Cavo C, Altchek DW, Dines D, Palletta G, Wickiewicz TL: Arthroscopic assisted rotator cuff repair: results using a mini-open deltoid splitting approach. Arthroscopy. 1996, 12 (1): 50-59.PubMed

27.

Warner JJ, Goitz RJ, Irrgang JJ, Groff YJ: Arthroscopic-assisted rotator cuff repair: patient selection and treatment outcome. J Shoulder Elbow Surg. 1997, 6 (5): 463-472. 10.1016/S1058-2746(97)70054-5.PubMed

28.

Park JY, Levine WN, Marra G, Pollock RG, Flatow EL, Bigliani LU: Portal-extension approach for the repair of small and medium rotator cuff tears. Am J Sports Med. 2000, 28 (3): 312-316.PubMed

29.

Posada A, Uribe JW, Hechtman KS, Tjin-A-Tsoi EW, Zvijac JE: Mini-deltoid splitting rotator cuff repair: do results deteriorate with time?. Arthroscopy. 2000, 16 (2): 137-141.PubMed

30.

Hersch JC, Sgaglione NA: Arthroscopically assisted mini-open rotator cuff repairs. Functional outcome at 2- to 7-year follow-up. Am J Sports Med. 2000, 28 (3): 301-311.PubMed

31.

Fealy S, Kingham TP, Altchek DW: Mini-open rotator cuff repair using a two-row fixation technique: outcomes analysis in patients with small, moderate, and large rotator cuff tears. Arthroscopy. 2002, 18 (6): 665-670.PubMed

32.

Shinners TJ, Noordsij PG, Orwin JF: Arthroscopically assisted mini-open rotator cuff repair. Arthroscopy. 2002, 18 (1): 21-26.PubMed

33.

Severud EL, Ruotolo C, Abbott DD, Nottage WM: All-arthroscopic versus mini-open rotator cuff repair: A long-term retrospective outcome comparison. Arthroscopy. 2003, 19 (3): 234-238.PubMed

34.

Gartsman GM, Khan M, Hammerman SM: Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 1998, 80 (6): 832-840.PubMed

35.

Tauro JC: Arthroscopic rotator cuff repair: analysis of technique and results at 2- and 3-year follow-up. Arthroscopy. 1998, 14 (1): 45-51.PubMed

36.

Burkhart SS, Danaceau SM, Pearce CEJ: Arthroscopic rotator cuff repair: Analysis of results by tear size and by repair technique-margin convergence versus direct tendon-to-bone repair. Arthroscopy. 2001, 17 (9): 905-912.PubMed

37.

Murray TF, Lajtai G, Mileski RM, Snyder SJ: Arthroscopic repair of medium to large full-thickness rotator cuff tears: outcome at 2- to 6-year follow-up. J Shoulder Elbow Surg. 2002, 11 (1): 19-24. 10.1067/mse.2002.120142.PubMed

38.

Wilson F, Hinov V, Adams G: Arthroscopic repair of full-thickness tears of the rotator cuff: 2- to 14-year follow-up. Arthroscopy. 2002, 18 (2): 136-144.PubMed

39.

Hata Y, Saitoh S, Murakami N, Kobayashi H, Takaoka K: Atrophy of the deltoid muscle following rotator cuff surgery. J Bone Joint Surg Am. 2004, 86-A (7): 1414-1419.PubMed

40.

Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh I: Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years' follow-up. Arthroscopy. 2003, 19 (7): 746-754.PubMed

41.

Gartsman GM, Brinker MR, Khan M: Early effectiveness of arthroscopic repair for full-thickness tears of the rotator cuff: an outcome analysis. J Bone Joint Surg Am. 1998, 80 (1): 33-40. 10.1302/0301-620X.80B1.7919.PubMed

42.

Itoi E, Tabata S: Incomplete rotator cuff tears. Results of operative treatment. Clin Orthop Relat Res. 1992, 284: 128-135.PubMed

43.

Lippit SB, Harryman DT, Matsen FA: A practical tool for evaluating function: the Simple Shoulder Test. The Shoulder: A Balance of Mobility and Stability. Edited by: Matsen FA, Fu FH, Hawkins RJ. 1993, Rosemont , American Academy of Orthopaedic Surgeons, 501-518.

44.

Robertson O, Dunbar MJ: Patient satisfaction compared with general health and disease-specific questionnaires in knee arthroplasty patients. J Arthroplasty. 2001, 16 (4): 476-482. 10.1054/arth.2001.22395a.

45.

Hurst NP, Ruta DA, Kind P: Comparison of the MOS short form-12 (SF12) health status questionnaire with the SF36 in patients with rheumatoid arthritis. Br J Rheumatol. 1998, 37 (8): 862-869. 10.1093/rheumatology/37.8.862.PubMed

46.

Codman EA: Complete rupture of the supraspinatus tendon: Operative treatment with report of two successful cases. Boston Med Surg J. 1911, 164 (164): 708-710.

47.

Klepps S, Bishop J, Lin J, Cahion O, Strauss A, Hayes P, Flatow EL: Prospective evaluation of the effect of rotator cuff integrity on the outcome of open rotator cuff repairs. Am J Sports Med. 2004, 32 (7): 1716-1722. 10.1177/0363546504265262.PubMed

48.

Iannotti JP: Full-Thickness Rotator Cuff Tears: Factors Affecting Surgical Outcome. J Am Acad Orthop Surg. 1994, 2 (2): 87-95.PubMed

49.

Neer CSII: Anterior acromioplasty for the chronic impingement syndrome in the shoulder. A preliminary report. J Bone Joint Surg. 1972, 54-A: 41-50.

50.

Samilson RL, Binder WF: Symptomatic full thickness tears of rotator cuff. An analysis of 292 shoulders in 276 patients. Orthop Clin North Am. 1975, 6 (2): 449-466.PubMed

51.

Cordasco FA, Bigliani LU: The treatment of failed rotator cuff repairs. Instr Course Lect. 1998, 47: 77-86.PubMed

52.

Groh GI, Simoni M, Rolla P, Rockwood C: Loss of the deltoid after shoulder operations: an operative disaster. J Shoulder Elbow Surg. 1994, 3: 243-253.PubMed

53.

Post M, Silver R, Singh M: Rotator cuff tear: diagnosis and treatment. Clin Orthop Relat Res. 1983, 173: 78-91.PubMed

54.

Baker CL, Liu SH: Comparison of open and arthroscopically assisted rotator cuff repairs. Am J Sports Med. 1995, 23 (1): 99-104. 10.1177/036354659502300117.PubMed

55.

Beach WR, Caspari RB: Arthroscopic management of rotator cuff disease. Orthopedics. 1993, 16 (9): 1007-1015.PubMed

56.

Flynn LM, Flood SJ, Clifford S, Brown T, Jongko T, Brannan J, Sloan KW: Arthroscopically assisted rotator cuff repair with the Mitek anchor. Arthroscopy. 1991, 1 (7): 15-18.

57.

Liu SH: Arthroscopically-assisted rotator-cuff repair. J Bone Joint Surg Br. 1994, 76 (4): 592-595.PubMed

58.

Warner JJP, Altchek DW, Warren RF: Arthroscopic management of rotator cuff tears with emphasis on the throwing athlete. Oper Tech Orthop. 1991, 1: 235-239. 10.1016/S1048-6666(05)80017-5.

59.

Weber SC, Schaefer R: "Mini-open" versus traditional open repair in the management of small and moderate size tears of the rotator cuff. (Abstract). Arthroscopy. 1993, 9: 365-366.

60.

Yamaguchi K, Flatow EL: Arthroscopic evaluation and treatment of the rotator cuff. Orthop Clin North Am. 1995, 26 (4): 643-659.PubMed

61.

Zvijac JE, Levy HJ, Lemak LJ: Arthroscopic subacromial decompression in the treatment of full thickness rotator cuff tears: a 3- to 6-year follow-up. Arthroscopy. 1994, 10 (5): 518-523.PubMed

62.

Johnson LL: Rotator Cuff. Diagnostic and Surgical Arthroscopy of the Shoulder. Edited by: Johnson LL. 1993, St. Louis , Mosby, 365-405.

63.

McLaughlin HL: Lesions of the musculotendinous cuff of the shoulder. The exposure and treatment of tears with retraction. 1944. Clin Orthop Relat Res. 1994, 304: 3-9.PubMed

64.

Lo IK, Burkhart SS: Double-row arthroscopic rotator cuff repair: re-establishing the footprint of the rotator cuff. Arthroscopy. 2003, 19 (9): 1035-1042.PubMed

65.

Placzek JD, Lukens SC, Badalanmenti S, Roubal PJ, Freeman DC, Walleman KM, Parrot A, Wiater JM: Shoulder outcome measures: a comparison of 6 functional tests. Am J Sports Med. 2004, 32 (5): 1270-1277. 10.1177/0363546503262193.PubMed

66.

Prickett WD, Teefey SA, Galatz LM, Calfee RP, Middleton WD, Yamaguchi K: Accuracy of ultrasound imaging of the rotator cuff in shoulders that are painful postoperatively. J Bone Joint Surg Am. 2003, 85-A (6): 1084-1089.PubMed

Title: The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up
Authors: Albert W Pearsall IV
Khalid A Ibrahim
Sudhakar G Madanagopal
Publication date: 01-12-2007
Publisher: BioMed Central
Published in: Journal of Orthopaedic Surgery and Research / Issue 1/2007
Electronic ISSN: 1749-799X
DOI: https://doi.org/10.1186/1749-799X-2-24

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Level of Evidence

Please log in to get access to this content

Other articles of this Issue 1/2007

Comparison of effectiveness of Halo-femoral traction after anterior spinal release in severe idiopathic and congenital scoliosis: a retrospective study

Development of an in vitro three dimensional loading-measurement system for long bone fixation under multiple loading conditions: a technical description

Proliferating and differentiating effects of three different growth factors on pluripotent mesenchymal cells and osteoblast like cells

Tibial shaft fractures in football players

Experimental and analytical validation of a modular acetabular prosthesis in total hip arthroplasty

Histomorphological study of the spinal growth plates from the convex side and the concave side in adolescent idiopathic scoliosis