title: Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years' follow-up.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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.
authors.affiliation: Department of Orthopaedic Surgery, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, South Korea. smcknot@hotmail.com
authors.forename: Seung-Ho
authors.initials: SH
authors.lastname: Kim
authors.forename: Kwon-Ick
authors.initials: KI
authors.lastname: Ha
authors.forename: Jong-Hyuk
authors.initials: JH
authors.lastname: Park
authors.forename: Jin-Seok
authors.initials: JS
authors.lastname: Kang
authors.forename: Sung-Kyun
authors.initials: SK
authors.lastname: Oh
authors.forename: Irvin
authors.initials: I
authors.lastname: Oh
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D016879:Salvage Therapy; D012720:Severity of Illness Index; D016896:Treatment Outcome