Arthroscopic versus mini-open rotator cuff repair: A meta-analysis

Area of Science:

• Orthopedic Surgery
• Sports Medicine
• Shoulder Reconstruction

Background:

• Mini-open and all-arthroscopic rotator cuff repairs are prevalent surgical procedures.
• Uncertainty exists regarding the comparative superiority of these two surgical approaches.

Purpose of the Study:

• To compare the clinical and structural outcomes of mini-open versus all-arthroscopic rotator cuff repair techniques.
• To synthesize evidence from existing comparative studies to inform surgical decision-making.

Main Methods:

• A systematic review and meta-analysis of comparative studies was conducted.
• Searches included PubMed, Scopus, Cochrane, and Google Scholar up to November 2025.
• Thirty-three studies (6 RCTs, 27 cohort studies) with 1980 patients were analyzed for outcomes including operative time, range of motion, functional scores, pain, and re-tear rates.

Main Results:

• No significant differences were observed in shoulder range of motion (flexion, abduction, internal/external rotation) between the two techniques.
• Functional outcome scores (ASES, Constant, UCLA, DASH) were comparable across both groups.
• Arthroscopic repair showed a trend towards slightly lower postoperative VAS pain scores (p=0.002).
• Re-tear rates, operative time, satisfaction, and complication rates were similar between mini-open and arthroscopic repairs.

Conclusions:

• Both mini-open and arthroscopic rotator cuff repair techniques demonstrate comparable clinical and structural outcomes.
• Arthroscopy may offer a modest advantage in pain reduction, though evidence is limited by non-randomized studies.
• Surgeon expertise and patient-specific priorities should guide the selection between mini-open and arthroscopic approaches.