Abstract

Aim: This study aimed to compare the functional and clinical results of all arthroscopic (AA) and arthroscopic-assisted mini open (AAMO) rotator cuff tear (RCT) repair methods with a minimum 2 years follow-up.

Methods: In this retrospective study, patients who operated with the AA repair method were included in group 1 and patients who operated with AAMO RCT repair method were included in group 2. Between January 2018 and June 2021. All patients were evaluated with shoulder range of motion (ROM), the Disabilities of the Arm, Shoulder and Hand (DASH), Constant Murley Score (CMS) and visual analog scale (VAS) pain score preoperatively and postoperatively. Postoperative evaluation was made on the 3rd, 6th, 12th, and 24th months. In addition, the length of hospital stay, and surgery time were evaluated.

Results: Eighty patients (48 female, 32 male) were included in group 1, who were treated with the AA technique. Sixty-seven patients (28 male, 39 female) were included in group 2, who were treated with the AAMO technique. The average follow-up time was 29,36 ±3,48 months for group 1, 28,12±2,87 months for group 2. No significant difference was detected between group 1 and group 2 for length of hospital stay and follow-up time (p>0,05). At the postoperative 3rd-month follow-up measurements, a statistically significant difference was determined between group 1 and group 2 for abduction, flexion measurements, VAS score, and DASH score (p=0,03, p=0,04, p=0,02, p=0,01 respectively). At the 24th month postoperative follow-up, statistically no significant difference was determined between groups 1 and 2 in terms of ROM, VAS, and functional scores.

Conclusion: In the early recovery period, AA repair provides better ROM, DASH, and VAS scores. However, in long-term follow-up, no significant difference was detected in AA and AAMO repair in terms of functional results, ROM, and VAS scores.

Keywords: arthroscopic-assisted mini open repair, arthroscopic repair, rotator cuff tear

Copyright and license

How to cite

1.
Kılıç E, Sarıkaya B. Comparison of arthroscopic-assisted mini open and all arthroscopic repair methods in small to large size rotator cuff tears. Northwestern Med J. 2024;4(4):181-7. https://doi.org/10.54307/2024.NWMJ.72

References

  1. Burkhart SS, Lo IK. Arthroscopic rotator cuff repair. J Am Acad Orthop Surg. 2006; 14(6): 333-46. https://doi.org/10.5435/00124635-200606000-00003
  2. Yamamoto A, Takagishi K, Osawa T, et al. Prevalence and risk factors of a rotator cuff tear in the general population. J Shoulder Elbow Surg. 2010; 19(1): 116-20. https://doi.org/10.1016/j.jse.2009.04.006
  3. Codman EA. Complete rupture of the supraspinatus tendon. Operative treatment with report of two successful cases. 1911. J Shoulder Elbow Surg. 2011; 20(3): 347-9. https://doi.org/10.1016/j.jse.2010.10.031
  4. Migliorini F, Maffulli N, Eschweiler J, Schenker H, Tingart M, Betsch M. Arthroscopic versus mini-open rotator cuff repair: A meta-analysis. Surgeon. 2023; 21(1): e1-12. https://doi.org/10.1016/j.surge.2021.11.005
  5. MacDermid JC, Bryant D, Holtby R, et al. Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis. Am J Sports Med. 2021; 49(12): 3184-95. https://doi.org/10.1177/03635465211038233
  6. Ozcan MS, Varol A, Kilinc BE. Arthroscopic versus Mini-Open Rotator Cuff Repair: Should We Ignore the Mini-Open Surgery? Acta Chir Orthop Traumatol Cech. 2021; 88(5): 369-74.
  7. Sauerbrey AM, Getz CL, Piancastelli M, Iannotti JP, Ramsey ML, Williams GR. Arthroscopic versus mini-open rotator cuff repair: a comparison of clinical outcome. Arthroscopy. 2005; 21(12): 1415-20. https://doi.org/10.1016/j.arthro.2005.09.008
  8. Verma NN, Dunn W, Adler RS, et al. All-arthroscopic versus mini-open rotator cuff repair: a retrospective review with minimum 2-year follow-up. Arthroscopy. 2006; 22(6): 587-94. https://doi.org/10.1016/j.arthro.2006.01.019
  9. Ji X, Bi C, Wang F, Wang Q. Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials. Arthroscopy. 2015; 31(1): 118-24. https://doi.org/10.1016/j.arthro.2014.08.017
  10. 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(1): 71-7. https://doi.org/10.2106/00004623-200101000-00010
  11. Yamaguchi K, Levine WN, Marra G, Galatz LM, Klepps S, Flatow EL. Transitioning to arthroscopic rotator cuff repair: the pros and cons. Instr Course Lect. 2003; 52: 81-92.
  12. Levy HJ, Uribe JW, Delaney LG. Arthroscopic assisted rotator cuff repair: preliminary results. Arthroscopy. 1990; 6(1): 55-60. https://doi.org/10.1016/0749-8063(90)90099-y
  13. Churchill RS, Ghorai JK. Total cost and operating room time comparison of rotator cuff repair techniques at low, intermediate, and high volume centers: mini-open versus all-arthroscopic. J Shoulder Elbow Surg. 2010; 19(5): 716-21. https://doi.org/10.1016/j.jse.2009.10.011
  14. Nho SJ, Shindle MK, Sherman SL, Freedman KB, Lyman S, MacGillivray JD. Systematic review of arthroscopic rotator cuff repair and mini-open rotator cuff repair. J Bone Joint Surg Am. 2007; 89 Suppl 3: 127-36. https://doi.org/10.2106/JBJS.G.00583
  15. Kang L, Henn RF, Tashjian RZ, Green A. Early outcome of arthroscopic rotator cuff repair: a matched comparison with mini-open rotator cuff repair. Arthroscopy. 2007; 23(6): 573-82. https://doi.org/10.1016/j.arthro.2007.01.011
  16. Liu J, Fan L, Zhu Y, Yu H, Xu T, Li G. Comparison of clinical outcomes in all-arthroscopic versus mini-open repair of rotator cuff tears: A randomized clinical trial. Medicine (Baltimore). 2017; 96(11): e6322. https://doi.org/10.1097/MD.0000000000006322
  17. Shen C, Tang ZH, Hu JZ, Zou GY, Xiao RC, Yan DX. Does immobilization after arthroscopic rotator cuff repair increase tendon healing? A systematic review and meta-analysis. Arch Orthop Trauma Surg. 2014; 134(9): 1279-85. https://doi.org/10.1007/s00402-014-2028-2
  18. van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, Lindenburg R, Swen JWA, van Arkel ERA. Clinical outcome in all-arthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: a randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy. 2013; 29(2): 266-73. https://doi.org/10.1016/j.arthro.2012.08.022
  19. Wright RW, Baumgarten KM. Shoulder outcomes measures. J Am Acad Orthop Surg. 2010; 18(7): 436-44. https://doi.org/10.5435/00124635-201007000-00006
  20. Cho CH, Song KS, Jung GH, Lee YK, Shin HK. Early postoperative outcomes between arthroscopic and mini-open repair for rotator cuff tears. Orthopedics. 2012; 35(9): e1347-52. https://doi.org/10.3928/01477447-20120822-20
  21. Park JY, Lhee SH, Oh KS, Moon SG, Hwang JT. Clinical and ultrasonographic outcomes of arthroscopic suture bridge repair for massive rotator cuff tear. Arthroscopy. 2013; 29(2): 280-9. https://doi.org/10.1016/j.arthro.2012.09.008
  22. Köse KC, Tezen E, Cebesoy O, et al. Mini-open versus all-arthroscopic rotator cuff repair: comparison of the operative costs and the clinical outcomes. Adv Ther. 2008; 25(3): 249-59. https://doi.org/10.1007/s12325-008-0031-0
  23. Zhang Z, Gu B, Zhu W, Zhu L, Li Q. Arthroscopic versus mini-open rotator cuff repair: a prospective, randomized study with 24-month follow-up. Eur J Orthop Surg Traumatol. 2014; 24(6): 845-50. https://doi.org/10.1007/s00590-013-1263-5