A randomized clinical trial comparing open to arthroscopic acromioplasty with mini-open rotator cuff repair for full-thickness rotator cuff tears: disease-specific quality of life outcome at an average 2-year follow-up.
BACKGROUND
Rotator cuff tears affect patients' quality of life. The evolution toward less invasive operative techniques for rotator cuff repair requires appropriate comparisons with the standard open procedure, using validated outcomes in a randomized fashion.


OBJECTIVE
There is no difference in disease-specific quality of life outcomes at 2 years between an open surgical repair (open) versus an arthroscopic acromioplasty with mini-open (scope mini-open) repair for patients with full-thickness rotator cuff tears.


METHODS
Randomized controlled trial; Level of evidence, 1.


METHODS
Patients with unremitting pain, failed nonoperative treatment, and imaging indicating full-thickness rotator cuff tears were included in the study. Massive irreparable cuff tears were excluded. Patients were assessed using the disease-specific Rotator Cuff-Quality of Life index, which produces a maximum score of 100, representing a high quality of life. Secondary shoulder-specific outcomes (American Shoulder and Elbow Society, Shoulder Rating Questionnaire, and Functional Shoulder Elevation Test) were also measured at baseline, 3 and 6 months, and 1 and 2 years.


RESULTS
The mean Rotator Cuff-Quality of Life scores at an average follow-up of 28 months were not statistically different: open, 86.9 (95% confidence interval: 81.8-92.0); and scope mini-open, 87.2 (95% confidence interval: 80.6-93.8). At 3 months, the patients who underwent scope mini-open showed statistically significantly better outcomes (55.6 vs 71.3; P = .005). The baseline to 3-month difference in Rotator Cuff-Quality of Life scores between the scope mini-open and open groups was also statistically significant.


CONCLUSIONS
Patient outcomes improved from baseline to all postoperative measurement intervals. There was no difference in outcome at 1 and 2 years after surgery between the scope mini-open and open procedures. The quality of life of patients undergoing the arthroscopic acromioplasty with mini-open rotator cuff repair improved statistically significantly and clinically at 3 months compared with the open group.
Mohtadi
Nicholas G
NG
University of Calgary Sport Medicine Centre, 2500 University Drive NW, Calgary, Alberta, Canada. mohtadi@ucalgary.ca
Hollinshead
Robert M
RM
Sasyniuk
Treny M
TM
Fletcher
Jennifer A
JA
Chan
Denise S
DS
Li
Feng X
FX
D000173:Acromioclavicular Joint / Q000502:physiology; D000174:Acromion / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D001178:Arthroplasty / Q000379:methods*; D001182:Arthroscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications; D011788:Quality of Life; D016059:Range of Motion, Articular; D017006:Rotator Cuff / Q000601:surgery; D000070636:Rotator Cuff Injuries