Related Experiment Video
Updated: Oct 20, 2025
Arthroscopic Management of Massive Irreparable Rotator Cuff Tears: Whole Rotator Cable Reconstruction Using Proximal Biceps Tendon Autograft
Published on: June 6, 2025
Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis
Joy C MacDermid1,2, Dianne Bryant3,2, Richard Holtby4,2
1Departments of Surgery and Physical Therapy, University of Western Ontario, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, Ontario, Canada.
This study found that both mini-open (MO) and all-arthroscopic (AA) rotator cuff repair offer significant clinical benefits for patients with complete tears. There were no significant differences in outcomes between the two surgical methods.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Surgical Techniques
Background:
- Patients with complete rotator cuff tears unresponsive to nonoperative therapy may benefit from surgical intervention.
- Rotator cuff tears represent a significant cause of shoulder pain and disability.
Purpose of the Study:
- To compare the clinical outcomes of mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair in a randomized controlled trial.
- To evaluate the efficacy and safety of two distinct surgical approaches for rotator cuff repair.
Main Methods:
- A randomized controlled trial involving 274 patients undergoing either MO or AA rotator cuff repair across 9 centers.
- Outcomes including the Western Ontario Rotator Cuff Index (WORC), ASES score, SPADI, SF-12, range of motion, strength, and MRI-assessed tear integrity were collected preoperatively and up to 24 months postoperatively.
- Intention-to-treat analysis and a meta-analysis of previous trials were conducted.
Main Results:
- Both AA and MO groups showed significant improvements in WORC scores, with no statistically significant differences between the groups at any time point.
- Secondary patient-reported outcomes, range of motion, and strength were comparable between the MO and AA groups.
- MRI revealed minimal tendon healing, with most tears remaining unchanged or worsening, and a significant reduction in opioid use post-surgery.
Conclusions:
- Both all-arthroscopic and mini-open rotator cuff repair techniques provide substantial clinical benefits with a low incidence of adverse events.
- There is strong evidence supporting the equivalent clinical effectiveness of AA and MO rotator cuff repair.
