Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Imaging

Background:

• Arthroscopic rotator cuff repair (RCR) offers good clinical results but faces challenges with high retear rates.
• Assessing postoperative cuff integrity is crucial for understanding long-term outcomes.

Purpose of the Study:

• To prospectively evaluate postoperative rotator cuff integrity and clinical outcomes after arthroscopic RCR.
• To compare these outcomes with those of open RCR.

Main Methods:

• Prospective study involving 40 patients undergoing arthroscopic RCR and 32 patients undergoing open RCR.
• Preoperative and 1-year postoperative assessments included physical examination and magnetic resonance imaging (MRI).
• Evaluated American Shoulder and Elbow Surgeons (ASES) and Constant scores for clinical outcomes.

Main Results:

• Both arthroscopic and open RCR groups showed significant improvements in ASES and Constant scores (P < .0001).
• MRI revealed intact repairs in 53% of the arthroscopic group and 69% of the open group.
• Small tears (<3 cm) had comparable retear rates (84% arthroscopic vs. 74% open), while large tears (>3 cm) showed a significantly higher retear rate in the arthroscopic group (24% vs. 62%, P < .036).
• Intact cuffs after arthroscopic repair correlated with greater strength in elevation and external rotation.

Conclusions:

• Open and arthroscopic RCR yield similar clinical outcomes.
• Cuff integrity is comparable for small rotator cuff tears between the two methods.
• Large rotator cuff tears demonstrate a twofold higher retear rate following arthroscopic repair compared to open repair.