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Mini-open rotator cuff repair using a two-row fixation technique: outcomes analysis in patients with small, moderate,
Stephen Fealy1, T Peter Kingham, David W Altchek
1Department of Sports Medicine and Shoulder Service, Hospital for Special Surgery, Cornell University Medical College, New York, New York 10021, USA. fealys@hss.edu
Abstract:
Mini-open rotator cuff repair has been used successfully to treat small- and moderate-sized rotator cuff tears but not large tears (>3 cm and <5 cm). We use a 2-row fixation technique of repairing the torn cuff to the humerus. We sought to determine if this technique would produce successful results in patients with larger rotator cuff tears. The results of 75 consecutive patients who underwent arthroscopic subacromial decompression with acromioplasty and mini-open rotator cuff repair were evaluated. All patients were evaluated at a minimum 24 months postoperatively (mean, 27 months). All patients were treated with a mini-open rotator cuff repair using a 2-row fixation technique. Patients were evaluated at follow-up with a focused shoulder examination, Hospital for Special Surgery (HSS) Shoulder Questionnaire, and the University of California Los Angeles (UCLA) Shoulder Rating Scale. There were 49 male and 26 female patients, with a mean age of 54 years (range, 34-72 years). All patients failed a preoperative course of physical therapy and nonoperative management. Thirty patients were found to have a large rotator cuff tear (group I), 35 were found to have a moderate-sized tear (group II), and 10 patients had a small tear (group III) at the time of arthroscopy. There was no statistically significant difference in outcome between groups. The mean UCLA Shoulder Rating Scale for all groups was 33.6/35. Mean HSS Shoulder Questionnaire at follow-up was 91%. The mean time from surgery to full recovery was 7 months. Patient's subjective satisfaction based on their preinjury level of performance at most recent follow-up was 92.6%. Eighty-three percent (74/89) of patients returned to their preinjury activity; 93% of patients reported that they would undergo the procedure again. We believe that mini-open rotator cuff repair using a 2-row fixation technique can yield excellent results in patients with small, moderate, and large rotator cuff tears. There was no detectable difference in outcome between groups at 2-year follow-up on clinical evaluation.