No difference in long-term outcome between open and arthroscopic rotator cuff repair: a prospective, randomized study

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Musculoskeletal Imaging

Background:

• Arthroscopic rotator cuff repair is increasingly preferred over open techniques.
• Previous studies show comparable short- to mid-term outcomes.
• Long-term comparative data remains limited.

Purpose of the Study:

• To compare long-term clinical and imaging outcomes of arthroscopic versus open rotator cuff repair.
• To assess functional recovery, pain levels, and cuff integrity over >10 years.
• To evaluate potential deltoid muscle alterations associated with open repair.

Main Methods:

• Randomized trial of 40 patients with symptomatic rotator cuff tears (supraspinatus +/- infraspinatus).
• Patients underwent either arthroscopic or open rotator cuff repair.
• Clinical assessments (ROM, VAS, Constant-Murley Score, SSV) and imaging (radiography, MRI) at multiple time points up to >10 years post-op.

Main Results:

• No statistically significant differences in Constant-Murley scores or Subjective Shoulder Values between arthroscopic and open repair groups at >10 years.
• Median Constant-Murley scores were 79 (arthroscopic) vs. 84 (open); median Subjective Shoulder Values were 93% for both.
• MRI revealed a 30% retear rate in both groups, with no significant differences in deltoid muscle integrity or volume.

Conclusions:

• Arthroscopic and open rotator cuff repair yield comparable long-term clinical and radiographic outcomes.
• The open technique did not result in confirmed harm to the deltoid muscle.
• Findings suggest technique choice may not significantly impact long-term results for rotator cuff repair.