title: Effectiveness of open and arthroscopic rotator cuff repair (UKUFF): a randomised controlled trial.
abstract: OBJECTIVE
  The appropriate management for patients with a degenerative tear of the rotator cuff remains controversial, but operative treatment, particularly arthroscopic surgery, is increasingly being used. Our aim in this paper was to compare the effectiveness of arthroscopic with open repair of the rotator cuff.
  
  
  METHODS
  A total of 273 patients were recruited to a randomised comparison trial (136 to arthroscopic surgery and 137 to open surgery) from 19 teaching and general hospitals in the United Kingdom. The surgeons used their usual preferred method of repair. The Oxford Shoulder Score (OSS), two years post-operatively, was the primary outcome measure. Imaging of the shoulder was performed at one year after surgery. The trial is registered with Current Controlled Trials, ISRCTN97804283.
  
  
  RESULTS
  The mean OSS improved from 26.3 (standard deviation (sd) 8.2) at baseline, to 41.7 (sd 7.9) two years post-operatively for arthroscopic surgery and from 25.0 (sd 8.0) to 41.5 (sd 7.9) for open surgery. Intention-to-treat (ITT) analysis showed no statistical difference between the groups at two years (difference in OSS score -0.76; 95% confidence interval (CI) -2.75 to 1.22; p = 0.452). The confidence interval excluded the pre-determined clinically important difference in the OSS of three points. The rate of re-tear was not significantly different between the two groups (46.4% for arthroscopic and 38.6% for open surgery; 95% CI -6.9 to 25.8; p = 0.256). Healed repairs had the most improved OSS. These findings were the same when analysed per-protocol.
  
  
  CONCLUSIONS
  There is no evidence of difference in effectiveness between open and arthroscopic repair of rotator cuff tears. The rate of re-tear is high in both groups, for all sizes of tear and ages and this adversely affects the outcome. Cite this article: Bone Joint J 2017;99-B:107-15.
authors.affiliation: University of Oxford, Botnar Research Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: A
authors.initials: A
authors.lastname: Carr
authors.affiliation: University of Oxford, Botnar Research Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Cooper
authors.affiliation: University of Aberdeen, Health Services Research Unit, Foresterhill, Aberdeen, AB25 2ZD, UK.
authors.forename: M K
authors.initials: MK
authors.lastname: Campbell
authors.affiliation: University of Oxford, Botnar Research Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: J
authors.initials: J
authors.lastname: Rees
authors.affiliation: Nuffield Orthopaedic Centre, Oxford University Hospitals Trust, Windmill Road, Headington, Oxford, OX3 7HE, UK.
authors.forename: J
authors.initials: J
authors.lastname: Moser
authors.affiliation: University of Oxford, Botnar Research Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
authors.forename: D J
authors.initials: DJ
authors.lastname: Beard
authors.affiliation: University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
authors.forename: R
authors.initials: R
authors.lastname: Fitzpatrick
authors.affiliation: University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
authors.forename: A
authors.initials: A
authors.lastname: Gray
authors.affiliation: University of Oxford, Old Road Campus, OX3 7LF, UK.
authors.forename: J
authors.initials: J
authors.lastname: Dawson
authors.affiliation: University of Oxford, Old Road Campus, OX3 7LF, UK.
authors.forename: J
authors.initials: J
authors.lastname: Murphy
authors.affiliation: University of Aberdeen, Health Services Research Unit, Foresterhill, Aberdeen, AB25 2ZD, UK.
authors.forename: H
authors.initials: H
authors.lastname: Bruhn
authors.affiliation: University of Aberdeen, Health Services Research Unit, Foresterhill, Aberdeen, AB25 2ZD, UK.
authors.forename: D
authors.initials: D
authors.lastname: Cooper
authors.affiliation: University of Aberdeen, Health Services Research Unit, Foresterhill, Aberdeen, AB25 2ZD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Ramsay
mesh_terms: D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006769:Hospitals, General; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries / Q000601:surgery*; D016896:Treatment Outcome
keywords: Arthroscopic surgery; Open surgery; Randomised controlled trial; Rotator cuff repair