A comparison of the clinical outcomes between arthroscopic and open rotator cuff repair in patients with rotator cuff tear: A nonrandomized clinical trial

Zarezadeh, Abolghasem; Dehghani, Mohamad; Mohammadsharifi, Ghasem; Omidian, Ali

A comparison of the clinical outcomes between arthroscopic and open rotator cuff repair in patients with rotator cuff tear: A nonrandomized clinical trial

Document Type : Original Article

Authors

Department of Orthopedics, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Several researchers have investigated the clinical outcomes in patients with rotator cuff tear who compared open and arthroscopic surgeries; however, there are limited studies that have compared the outcomes of arthroscopic and open rotator cuff repair. This study was aimed to compare the clinical outcomes of the patients who underwent rotator cuff repair using either arthroscopic or open repair techniques. Materials and Methods: This is a prospective cohort study in which 51 patients who underwent either open or arthroscopic rotator cuff repair were studied. Twenty-six patients underwent open repair, and 25 patients had an arthroscopic repair. Patients were followed for 6–36 months. The outcome of the two groups was evaluated using the Universal California Los Angles (UCLA) score. Results: The mean tear size was 4.93 ± 2.3 cm² in the open surgery group and 4.99 ± 2.3 cm² in the arthroscopic group (P = 0.93). All patients showed significant improvement in their scores for pain, active forward flexion, active abduction, and function at the time of follow-up. Improvement in scores within each group was significant, but the comparison of the two techniques was not statistically significant in pain, active abduction, active forward flexion, and UCLA, but in function, the open surgery group was superior (P < 0.05). Conclusion: This study revealed that short-term outcomes for arthroscopic and open cuff repair are similar, except in function, which was significantly better in the open surgery.

Keywords

References

1.	Eren I, Ozben H, Gunerbuyuk C, Koyuncu Ö, Aygün MS, Hatipoglu E, et al. Rotator cuff tear characteristics: How comparable are the pre-operative MRI findings with intra-operative measurements following debridement during arthroscopic repair? Int Orthop 2019;43:1171-7.
2.	Kataoka T, Kokubu T, Muto T, Mifune Y, Inui A, Sakata R, et al. Rotator cuff tear healing process with graft augmentation of fascia lata in a rabbit model. J Orthop Surg Res 2018;13:200.
3.	Osti L, Buda M, Andreotti M, Gerace E, Osti R, Massari L, et al. Arthroscopic-assisted latissimus dorsi transfer for massive rotator cuff tear: A systematic review. Br Med Bull 2018;128:23-35.
4.	Kanji F, Naoya N, Taishi U, Hiroaki T. Arthroscopic superior capsule reconstruction for irreparable rotator cuff tear and axillary nerve palsy associated with anterior dislocation of the shoulder. J Orthop Case Rep 2018;8:100-3.
5.	Hata Y, Saitoh S, Murakami N, Seki H, Nakatsuchi Y, Takaoka K. A less invasive surgery for rotator cuff tear: Mini-open repair. J Shoulder Elbow Surg 2001;10:11-6.
6.	Ryösä A, Laimi K, čärimaa V, Lehtimäki K, Kukkonen J, Saltychev M. Surgery or conservative treatment for rotator cuff tear: A meta-analysis. Disabil Rehabil 2017;39:1357-63.
7.	Yoo JC, Lim TK, Kim DH, Koh KH. Comparison between the patients with surgery and without surgery after recommendation of surgical repair for symptomatic rotator cuff tear. J Orthop Sci 2018;23:64-9.
8.	Bayle X, Pham TT, Faruch M, Gobet A, Mansat P, Bonnevialle N. No difference in outcome for open versus arthroscopic rotator cuff repair: A prospective comparative trial. Arch Orthop Trauma Surg 2017;137:1707-12.
9.	Patte D. Classification of rotator cuff lesions. Clin Orthop Relat Res 1990; 1 (254):81-86:81-6.
10.	Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC. Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 1994;(304); 78-83:78-83.
11.	Kim JH, Hong IT, Ryu KJ, Bong ST, Lee YS, Kim JH. Retear rate in the late postoperative period after arthroscopic rotator cuff repair. Am J Sports Med 2014;42:2606-13.
12.	Iannotti JP, Deutsch A, Green A, Rudicel S, Christensen J, Marraffino S, et al. Time to failure after rotator cuff repair: A prospective imaging study. J Bone Joint Surg Am 2013;95:965-71.
13.	Ji X, Bi C, Wang F, Wang Q. Arthroscopic versus mini-open rotator cuff repair: An up-to-date meta-analysis of randomized controlled trials. Arthroscopy 2015;31:118-24.
14.	Lindley K, Jones GL. Outcomes of arthroscopic versus open rotator cuff repair: A systematic review of the literature. Am J Orthop (Belle Mead NJ) 2010;39:592-600.
15.	Kasten P, Keil C, Grieser T, Raiss P, Streich N, Loew M. Prospective randomised comparison of arthroscopic versus mini-open rotator cuff repair of the supraspinatus tendon. Int Orthop 2011;35:1663-70.
16.	van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, Lindenburg R, Swen JW, van Arkel ER. Clinical outcome in all-arthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: A randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy 2013;29:266-73.
17.	Buess E, Steuber KU, Waibl B. Open versus arthroscopic rotator cuff repair: A comparative view of 96 cases. Arthroscopy 2005;21:597-604.
18.	Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL. Cuff integrity after arthroscopic versus open rotator cuff repair: A prospective study. J Shoulder Elbow Surg 2006;15:290-9.
19.	Walton JR, Murrell GA. A two-year clinical outcomes study of 400 patients, comparing open surgery and arthroscopy for rotator cuff repair. Bone Joint Res 2012;1:210-7.
20.	Gumina S, Di Giorgio G, Perugia D, Postacchini F. Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 2008;32:81-4.
21.	Cho NS, Cha SW, Rhee YG. Alterations of the deltoid muscle after open versus arthroscopic rotator cuff repair. Am J Sports Med 2015;43:2927-34.
22.	Vopat BG, Lee BJ, DeStefano S, Waryasz GR, Kane PM, Gallacher SE, et al. Risk factors for infection after rotator cuff repair. Arthroscopy 2016;32:428-34.
23.	Owens BD, Williams AE, Wolf JM. Risk factors for surgical complications in rotator cuff repair in a veteran population. J Shoulder Elbow Surg 2015;24:1707-12.

Advanced Biomedical Research