Surgical Technique of Cuff Repair

A recent trend in rotator cuff repair surgery has been an apparent evolution from open repair techniques to “mini-open” repairs and, most recently, to arthroscopic repairs. The systematic review found no single comparative study that included all three techniques. One Level II ¹⁰⁸and two Level III¹⁰⁹, ¹¹⁰ studies address arthroscopic versus open rotator cuff repair in patients with full thickness tears.

The first study¹⁰⁸ compared open acromioplasty and rotator cuff repair to arthroscopic subacromial decompression with mini-open repair in a randomized trial with 73 patients. This study found early results favoring the mini-open technique up to one year after surgery (ASES, Rotator Cuff – Quality of Life Scale, and Shoulder Rating Questionnaire), but no statistically significant differences at 2-year follow-up. The second study¹⁰⁹ reported no statistically significant differences at 49 month follow-up on results of a non-randomized comparison of open and arthroscopic repair techniques. Lastly, in a non-randomized but controlled study comparing arthroscopic to mini-open repairs, the third author¹¹⁰ reported no differences at 36 months in the ASES and UCLA scores. The lack of comparisons between all three techniques makes it difficult to determine if any one technique should be preferred over another. Additionally, the apparent disagreement between the results of the included studies makes it difficult to recommend for or against a specific technique.