In a comparison of long-term outcomes of arthroscopic and open/mini-open rotator cuff repair, a new study shows that both techniques lead to similar long-term outcomes.
The study, “A Systematic Review of Long-term Clinical and Radiological Outcomes of Arthroscopic and Open/Mini-open Rotator Cuff Repairs,” was published online on February 18, 2022 in The American Journal of Sports Medicine.
“Arthroscopic rotator cuff repair has shown similar midterm functional results and retear rates as open/mini-open rotator cuff repair. A pooled analysis of long-term results of both techniques is yet missing,” the researchers wrote.
The team conducted a systematic review using the CENTRAL (Cochrane), MEDLINE (PubMed), and Embase databases. All studies that reported long-term clinical and radiographic outcomes of full-thickness arthroscopic rotator cuff repair and open/mini-open rotator cuff repair with a minimum follow-up of nine years were included.
Overall, 11 studies met the inclusion criteria: 5 studies on arthroscopic rotator cuff repair and 6 studies on open/mini-open rotator cuff repair. Five hundred and thirty-nine patients with 550 shoulders were analyzed in the review. Mean patient age was 56.3 years (range, 25-77).
The researchers reported that the mean preoperative absolute Constant Score and American Shoulder and Elbow Surgeons (ASES) shoulder score were significant improved postoperatively (CS, 44 to 78 points; ASES, 52% to 91%; both comparisons, p < .001).
The retear rate was 41% (141 of 342 shoulders) without any between-group difference (arthroscopic Rotator Cuff Repair, 43%; open/mini-open rotator cuff repair, 39%; p = .364). A retear was associated with reduced absolute Constant Score as compared with a healed repair (p = .004).
“No significant differences were found in postoperative functional scores, complications, and retear rates after failed cuff repairs between the arthroscopic and open/mini-open repair groups,” the researchers wrote.
“Pooled analysis of arthroscopic and open rotator cuff repairs demonstrated sustained improvement in long-term shoulder scores and pain with a substantial retear rate in both groups, which was associated with inferior shoulder function. There were no significant differences in long-term functional outcomes, retear rates, and complications. Both surgical techniques may be used on the basis of factors such as patient or surgeon preference and cost. Further studies using a more robust randomized controlled trial or larger cohort design are recommended to ascertain whether one surgical repair technique is superior to the other.”
The study authors include Fabian Plachel, M.D., of Charité–Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Berlin, Germany, Olivia Imkyeong Jo, M.D., of Royal Melbourne Hospital, Katja Ruttershoff of Charité–Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Berlin, Germany, Octavian Andronic, M.D., of Balgrist University Hospital, University of Zurich in Switzerland and Lukas Ernstbrunner, M.D. of the Royal Melbourne Hospital and the University of Melbourne.
