Skip to main content
SpringerLink
Log in

No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial

  • Arthroscopy and Sports Medicine
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Purpose

Arthroscopic techniques tend to become the gold standard in rotator cuff repair. However, little data are reported in the literature regarding the improvement of postoperative outcomes and re-tear rate relative to conventional open surgery. The aim of this study was to compare clinical outcomes and cuff integrity after arthroscopic versus open cuff repair.

Methods

We prospectively assessed clinical outcomes and cuff integrity after an arthroscopic or open rotator cuff repair with a minimum follow-up of 12 months. Clinical evaluation was based on Constant score, Simple Shoulder Value (SSV) and American Shoulder and Elbow Score (ASES). Rotator cuff healing was explored with ultrasound.

Results

44 patients in arthroscopic group A (mean age 56-year-old) and 43 in open group O (mean age 61-year-old) fulfilled the inclusion criteria. Tendons were repaired with a single row technique associated with biceps tenodesis and subacromial decompression. All objective clinical scores significantly improved postoperatively in both groups. No statistical difference was identified between group A and O regarding, respectively, Constant score (72 vs 75 points; p = 0.3), ASES score (88 vs 91 points; p = 0.3), and SSV (81 vs 85%). The overall rate of re-tear (Sugaya type IV or V) reached 7 and 9%, respectively, in group A and O (p = 0.8).

Conclusion

This study did not prove any difference of arthroscopic over open surgery in case of rotator cuff repair regarding clinical outcome and cuff integrity at 1-year follow-up.

Level II

Prospective comparative study.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Dunn WR, Schackman BR, Walsh C et al (2005) Variation in orthopaedic surgeons’ perceptions about the indications for rotator cuff surgery. J Bone Jt Surg Am 87:1978–1984

    Article  Google Scholar 

  2. Acevedo DC, Paxton ES, Williams GR, Abboud JA (2014) A survey of expert opinion regarding rotator cuff repair. J Bone Jt Surg Am 16(96):e123

    Article  Google Scholar 

  3. Adla DN, Rowsell M, Pandey R (2010) Cost-effectiveness of open versus arthroscopic rotator cuff repair. J Shoulder Elbow Surg 19:258–261

    Article  PubMed  Google Scholar 

  4. Bishop J, Klepps S, Lo IK, Bird J, Gladstone JN, Flatow EL (2006) Cuff integrity after arthroscopic versus open rotator cuff repair: a prospective study. J Shoulder Elbow Surg 15:290–299

    Article  PubMed  Google Scholar 

  5. Boileau P, Brassart N, Watkinson DJ, Carles M, Hatzidakis AM, Krishnan SG (2005) Arthroscopic repair of full-thickness tears of the supraspinatus: does the tendon really heal? J Bone Jt Surg Am 87:1229–1240

    Google Scholar 

  6. Buess E, Steuber KU, Waibl B (2005) Open versus arthroscopic rotator cuff repair: a comparative view of 96 cases. Arthroscopy 21:597–604

    Article  PubMed  Google Scholar 

  7. Ide J, Maeda S, Takagi K (2005) A comparison of arthroscopic and open rotator cuff repair. Arthroscopy 21:1090–1098

    Article  PubMed  Google Scholar 

  8. Walton JR, Murrell GA (2012) A two-year clinical outcomes study of 400 patients, comparing open surgery and arthroscopy for rotator cuff repair. Bone Jt Res 1:210–217

    Article  CAS  Google Scholar 

  9. Constant CR, Murley AH (1987) A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res 214:160–164

    Google Scholar 

  10. Richards RR, An KN, Bigliani LU, Friedman RJ et al (1994) A standardized method for the assessment of shoulder function. J Shoulder Elbow Surg 3:347–352

    Article  CAS  PubMed  Google Scholar 

  11. Patte D (1990) Classification of rotator cuff lesions. Clin Orthop Relat Res 254:81–86

    Google Scholar 

  12. Goutallier D, Postel JM, Bernageau J, Lavau L, Voisin MC (1994) Fatty muscle degeneration in cuff ruptures. Pre- and postoperative evaluation by CT scan. Clin Orthop Relat Res 304:78–83

    Google Scholar 

  13. Sugaya H, Maeda K, Matsuki K, Moriishi J (2007) Repair integrity and functional outcome after arthroscopic double-row rotator cuff repair. A prospective outcome study. J Bone Jt Surg Am 89:953–960

    Google Scholar 

  14. Kim JH, Hong IT, Ryu KJ, Bong ST, Lee YS, Kim JH (2014) Retear rate in the late postoperative period after arthroscopic rotator cuff repair. Am J Sports Med 42:2606–2613

    Article  PubMed  Google Scholar 

  15. Iannotti JP, Deutsch A, Green A et al (2013) Time to failure after rotator cuff repair: a prospective imaging study. J Bone Jt Surg Am 95(11):965–971

    Article  Google Scholar 

  16. Ji X, Bi C, Wang F, Wang Q (2015) Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials. Arthroscopy 31:118–124

    Article  PubMed  Google Scholar 

  17. Kim SH, Ha KI, Park JH, Kang JS, Oh SK, Oh I (2003) Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years’ follow-up. Arthroscopy 19:746–754

    Article  PubMed  Google Scholar 

  18. Lindley K, Jones GL (2010) Outcomes of arthroscopic versus open rotator cuff repair: a systematic review of the literature. Am J Orthop (Belle Mead NJ) 39:592–600

    Google Scholar 

  19. van der Zwaal P, Thomassen BJ, Nieuwenhuijse MJ, Lindenburg R, Swen JW, van Arkel ER (2012) Clinical outcome in all-arthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: a randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy 29:266–273

    Article  PubMed  Google Scholar 

  20. Youm T, Murray DH, Kubiak EN, Rokito AS, Zuckerman JD (2005) Arthroscopic versus mini-open rotator cuff repair: a comparison of clinical outcomes and patient satisfaction. J Shoulder Elbow Surg 14:455–459

    Article  PubMed  Google Scholar 

  21. Osti L, Papalia R, Paganelli M, Denaro E, Maffulli N (2010) Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study. Int Orthop 34:389–394

    Article  PubMed  Google Scholar 

  22. Kasten P, Keil C, Grieser T, Raiss P, Streich N, Loew M (2011) Prospective randomised comparison of arthroscopic versus mini-open rotator cuff repair of the supraspinatus tendon. Int Orthop 35:1663–1670

    Article  PubMed  PubMed Central  Google Scholar 

  23. Gumina S, Di Giorgio G, Perugia D, Postacchini F (2008) Deltoid detachment consequent to open surgical repair of massive rotator cuff tears. Int Orthop 32:81–84

    Article  CAS  PubMed  Google Scholar 

  24. Cho NS, Cha SW, Rhee YG (2015) Alterations of the deltoid muscle after open versus arthroscopic rotator cuff repair. Am J Sports Med 43:2927–2934

    Article  PubMed  Google Scholar 

  25. Vopat BG, Lee BJ, DeStefano S et al (2016) Risk factors for infection after rotator cuff repair. Arthroscopy 32:428–434

    Article  PubMed  Google Scholar 

  26. Owens BD, Williams AE, Wolf JM (2015) Risk factors for surgical complications in rotator cuff repair in a veteran population. J Shoulder Elbow Surg 24:1707–1712

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Hôpital Riquet, Place Baylac, 31059, Toulouse, France

    Xavier Bayle, Thuy-Trang Pham, Pierre Mansat & Nicolas Bonnevialle

  2. Department of Radiology, Hôpital Riquet, Place Baylac, 31059, Toulouse, France

    Marie Faruch

  3. Department of Epidemiology and Public Health, Hôpital Pellegrin, Place Amélie Raba Leon, 33076, Bordeaux, France

    Aurelie Gobet

  4. Centre Hospitalier Universitaire de Purpan, Place Baylac, 31059, Toulouse, France

    Nicolas Bonnevialle

Authors
  1. Xavier Bayle
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Thuy-Trang Pham
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Marie Faruch
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Aurelie Gobet
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pierre Mansat
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Nicolas Bonnevialle
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nicolas Bonnevialle.

Ethics declarations

Financial biases

None.

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

IRB approval: Approved study on number 17-0313.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Bayle, X., Pham, TT., Faruch, M. et al. No difference in outcome for open versus arthroscopic rotator cuff repair: a prospective comparative trial. Arch Orthop Trauma Surg 137, 1707–1712 (2017). https://doi.org/10.1007/s00402-017-2796-6

Download citation

  • Received:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00402-017-2796-6

Keywords

Search

Navigation