A comparison of arthroscopic and open rotator cuff repair.
OBJECTIVE
The purpose of this study was to compare the results of all-arthroscopic repair of full-thickness rotator cuff tears including massive tear with those of open repair.


METHODS
Nonrandomized control study.


METHODS
We evaluated 100 consecutive patients (100 shoulders) who were treated for full-thickness rotator cuff tears either by all-arthroscopic (50 patients) or open repair (50 patients). The mean age was 57 years (range, 24 to 78 years). The mean follow-up period was 49 months (range, 25 to 83 months). Of all the patients, 7 had a small tear, 63 a medium tear, 17 a large tear, and 13 a massive tear; in the arthroscopic group, 5 had a small tear, 28 a medium tear, 9 a large tear, and 8 a massive tear. The results of the arthroscopic and open groups were compared using the shoulder rating scale of the University of California at Los Angeles (UCLA) and the Japanese Orthopaedic Association (JOA).


RESULTS
The 2 groups were statistically similar in terms of age, gender, trauma incidence, tear size, duration of symptoms, and preoperative shoulder scores. The UCLA and JOA scores improved significantly in both groups postoperatively. Outcomes and the postoperative UCLA and JOA scores were not significantly different between the 2 groups. The postoperative UCLA and JOA scores in patients with a large-to-massive tear were significantly lower than those with a small-to-medium tear, but outcomes were not statistically different between the arthroscopic and open groups depending on the tear size. The percentage of satisfactory results of arthroscopic and open repair for small-to-medium tears was 97.0% and 94.6%, respectively. Those of arthroscopic and open repair for large-to-massive tears was 82.4% and 76.9%, respectively.


CONCLUSIONS
Arthroscopic repair of small-to-massive tears had outcomes equivalent to those of open repair. Outcomes in patients with large-to-massive tears were inferior to those in patients with small-to-medium tears, regardless of repair method.


METHODS
Level III, case-control study.
Ide
Junji
J
Department of Orthopaedic Surgery, Kumamoto University Hospital, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. ide@kaiju.medic.kumamoto-u.ac.jp
Maeda
Satoshi
S
Takagi
Katsumasa
K
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012189:Retrospective Studies; D017006:Rotator Cuff / Q000473:pathology / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012720:Severity of Illness Index; D013536:Suture Techniques / Q000295:instrumentation; D016896:Treatment Outcome