title: The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years.
abstract: BACKGROUND
  The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery.
  
  
  METHODS
  Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time.
  
  
  RESULTS
  Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group.
  
  
  CONCLUSIONS
  At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.
authors: Orthopaedic Research Institute, Research & Education Centre, St George Hospital, Sydney, Australia.
authors: Thomas R
authors: TR
authors: Lucena
authors: Orthopaedic Research Institute, Research & Education Centre, St George Hospital, Sydney, Australia.
authors: Patrick H
authors: PH
authors: Lam
authors: Institute of Infection, Immunity and Inflammation and Department of Surgery, Glasgow, UK.
authors: Neal L
authors: NL
authors: Millar
authors: Orthopaedic Research Institute, Research & Education Centre, St George Hospital, Sydney, Australia.
authors: George Ac
authors: GA
authors: Murrell
keywords: Arthroscopic surgery; mini-open surgery; retear rate; rotator cuff; shoulder