Mini-Open Rotator Cuff Repair Technique

Before the rise of arthroscopic rotator cuff repair (RCR), mini-open RCR was the preferred method of repairing a torn rotator cuff. However, in the recent fluid shortage that limited the viability of performing arthroscopic procedures, we felt that mini-open RCR could be a viable method to achieve satisfactory patient outcomes while limiting arthroscopic fluid utilization. Little information, particularly in video form, exists describing how to perform a mini-open RCR.

Our patient presented with a symptomatic chronic rotator cuff tear that was affecting her ability to work. She wanted to undergo surgical intervention at a specific time to minimize the impact of the recovery time on her work. At that time, we were experiencing a fluid shortage, which limited our ability to perform arthroscopic procedures; thus, we elected to perform a mini-open RCR.

We utilized a small 4-cm incision on the lateral aspect of the shoulder and performed a deltoid split to expose the rotator cuff tear. In a similar fashion to an arthroscopic procedure, we debrided the rotator cuff footprint. We then performed a double-row transosseous equivalent repair through the open incision, as would be performed arthroscopically.

Previous literature suggests that mini-open RCR leads to similar functional and patient-reported outcomes as arthroscopic RCR. The open procedure may have a shorter operative time. Some evidence indicates that mini-open RCR may lead to an early increase in pain compared with arthroscopic repair, which tends to normalize within 1 week. We were able to limit the amount of arthroscopic fluid utilized to ≤3 L per case.

While mini-open RCR may be an older technique, there are instances when either arthroscopic equipment or fluid may not be available, and mini-open RCR may be the most viable technique for repair. Mini-open RCR can achieve satisfactory outcomes comparable to arthroscopic RCR.

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