Advances in Therapy

, Volume 25, Issue 3, pp 249–259

Mini-open versus all-arthroscopic rotator cuff repair: Comparison of the operative costs and the clinical outcomes

  • Kamil Çağri Köse
  • Engin Tezen
  • Oğuz Cebesoy
  • Engin Karadeniz
  • Dervis Guner
  • Sinan Adiyaman
  • Mehmet Demirtas



Rotator cuff injury is one of the most frequently encountered problems of the shoulder in the daily practice of orthopaedic surgeons. This study compared all-arthroscopic cuff repair (ARCR) and mini-open rotator cuff repair (MORCR) methods in regard to clinical outcomes and costs.


Fifty patient charts and operative repairs were analysed (25 ARCR and 25 MORCR). Pre-and postoperative Constant-Murley and UCLA scores along with factors such as tear size, tear type, pre-operative physical therapy, motion and satisfaction levels were compared for the two procedures. Cost-benefit analysis was also performed for comparison between procedures. The duration of follow-up was 31.20 and 21.56 months for MORCR and ARCR groups, respectively.


Tear sizes (P=0.68), pre-and postoperative Constant-Murley and UCLA scores (P=0.254) and satisfaction levels were not significantly different between groups. However, the differences between pre-and postoperative Constant-Murley and UCLA scores were statistically significant within both groups (P<0.01). The MORCR group stayed 1 day longer in hospital than the ARCR group, which was statistically significant (P=0.036). The differences regarding mean pain scores, abductions, internal and external rotations in Constant-Murley scores and forward flexion scores in UCLA scores were not significant. The ARCR group cost more, leaving less profit.


Results suggest that ARCR yields similar clinical results but at a higher cost compared with MORCR.

Key words

arthroscopic repair clinical outcome cost analysis mini-open repair rotator cuff tear 


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  1. 1.
    Codman EA. Rupture of the supraspinatus tendon. 1911. Clin Orthop Relat Res. 1990;(254):3-26.Google Scholar
  2. 2.
    Ellman H, Kay SP, Wirth M. Arthroscopic treatment of full-thickness rotator cuff tears: 2-to 7-year follow-up study. Arthroscopy. 1993;9:195–200.PubMedCrossRefGoogle Scholar
  3. 3.
    Tauro JC. Arthroscopic rotator cuff repair: analysis of technique and results at 2-and 3-year follow-up. Arthroscopy. 1998;14:45–51.PubMedCrossRefGoogle Scholar
  4. 4.
    Weber SC. Arthroscopic debridement and acromioplasty versus mini-open repair in the management of significant partialthickness tears of the rotator cuff. Orthop Clin North Am. 1997;28:79–82.PubMedCrossRefGoogle Scholar
  5. 5.
    Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;(214):160–164.Google Scholar
  6. 6.
    Amstutz HC, Sew Hoy AL, Clarke IC. UCLA anatomic total shoulder arthroplasty. Clin Orthop Relat Res. 1981;(155):7–20.Google Scholar
  7. 7.
    Demirhan M, Atalar AC, Kocabey Y, Akalin Y. Arthroscopic-assisted mini-open rotator cuff repair [in Turkish]. Acta Orthop Traumatol Turc. 2002;36:1–6.PubMedGoogle Scholar
  8. 8.
    Ellman H, Hanker G, Bayer M. Repair of the rotator cuff. End-result study of factors influencing reconstruction. J Bone Joint Surg Am. 1986;68:1136–1144.PubMedGoogle Scholar
  9. 9.
    Iannotti JP. Full-thickness rotator cuff tears: factors affecting surgical outcome. J Am Acad Orthop Surg. 1994;2:87–95.PubMedGoogle Scholar
  10. 10.
    Gartsman GM, Khan M, Hammerman SM. Arthroscopic repair of full-thickness tears of the rotator cuff. J Bone Joint Surg Am. 1998;80:832–840.PubMedGoogle Scholar
  11. 11.
    Liu SH, Baker CL. Arthroscopically assisted rotator cuff repair: correlation of functional results with integrity of the cuff. Arthroscopy. 1994;10:54–60.PubMedCrossRefGoogle Scholar
  12. 12.
    Warner JJ, Goitz RJ, Irrgang JJ, Groff YJ. Arthroscopic-assisted rotator cuff repair: patient selection and treatment outcome. J Shoulder Elbow Surg. 1997;6:463–472.PubMedCrossRefGoogle Scholar
  13. 13.
    Weber SC, Schaefer R. “Mini open” versus traditional open repair in the management of small and moderate size tears of the rotator cuff. Arthroscopy. 1993;9:365–366.Google Scholar
  14. 14.
    Norberg FB, Field LD, Savoie FH 3rd. Repair of the rotator cuff. Mini-open and arthroscopic repairs. Clin Sports Med. 2000;19:77–99.PubMedCrossRefGoogle Scholar
  15. 15.
    Severud EL, Ruotolo C, Abbott DD, Nottage WM. All-arthroscopic versus mini-open rotator cuff repair: a longterm retrospective outcome comparison. Arthroscopy. 2003;19:234–238.PubMedCrossRefGoogle Scholar
  16. 16.
    Verma NN, Dunn W, Adler RS, et al. All-arthroscopic versus mini-open rotator cuff repair: a retrospective review with minimum 2-year follow-up. Arthroscopy. 2006;22:587–594.PubMedCrossRefGoogle Scholar
  17. 17.
    Youm T, Murray DH, Kubiak EN, Rokito AS, Zuckerman JD. Arthroscopic versus mini-open rotator cuff repair: a comparison of clinical outcomes and patient satisfaction. J Shoulder Elbow Surg. 2005;14:455–459.PubMedCrossRefGoogle Scholar
  18. 18.
    Hersch JC, Sgaglione NA. Arthroscopically assisted mini-open rotator cuff repairs. Functional outcome at 2-to 7-year follow-up. Am J Sports Med. 2000;28:301–311.PubMedGoogle Scholar
  19. 19.
    Cofield RH, Parvizi J, Hoffmeyer PJ, Lanzer WL, Ilstrup DM, Rowland CM. Surgical repair of chronic rotator cuff tears. A prospective long-term study. J Bone Joint Surg Am. 2001;83-A:71–77.PubMedGoogle Scholar
  20. 20.
    Gazielly DF, Gleyze P, Montagnon C. Functional and anatomical results after rotator cuff repair. Clin Orthop Relat Res. 1994;(304):43–53.Google Scholar
  21. 21.
    Matthews TJ, Hand GC, Rees JL, Athanasou NA, Carr AJ. Pathology of the torn rotator cuff tendon. Reduction in potential for repair as tear size increases. J Bone Joint Surg Br. 2006;88:489–495.PubMedCrossRefGoogle Scholar
  22. 22.
    McCabe RA, Nicholas SJ, Montgomery KD, Finneran JJ, McHugh MP. The effect of rotator cuff tear size on shoulder strength and range of motion. J Orthop Sports Phys Ther. 2005;35:130–135.PubMedGoogle Scholar
  23. 23.
    Motycka T, Kriegleder B, Landsiedl F. Results of open repair of the rotator cuff-a long-term review of 79 shoulders. Arch Orthop Trauma Surg. 2001;121:148–151.PubMedCrossRefGoogle Scholar
  24. 24.
    Romeo AA, Hang DW, Bach BR Jr, Shott S. Repair of full thickness rotator cuff tears. Gender, age, and other factors affecting outcome. Clin Orthop Relat Res. 1999;(367):243–255.Google Scholar
  25. 25.
    Hata Y, Saitoh S, Murakami N, Seki H, Nakatsuchi Y, Takaoka K. A less invasive surgery for rotator cuff tear: mini-open repair. J Shoulder Elbow Surg. 2001;10:11–16.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Healthcare Communications 2008

Authors and Affiliations

  • Kamil Çağri Köse
    • 1
  • Engin Tezen
    • 2
  • Oğuz Cebesoy
    • 3
  • Engin Karadeniz
    • 4
  • Dervis Guner
    • 5
  • Sinan Adiyaman
    • 5
  • Mehmet Demirtas
    • 5
  1. 1.Department of Orthopaedics and TraumatologyAfyon Kocatepe University Faculty of MedicineAfyonTurkey
  2. 2.Department of Orthopaedics and TraumatologyYozgat Yerkoy State HospitalYozgatTurkey
  3. 3.Department of Orthopaedics and TraumatologyGaziantep University Faculty of MedicineGaziantepTurkey
  4. 4.Department of Orthopaedics and TraumatologyBingöl State HospitalBingölTurkey
  5. 5.Department of Orthopaedics and TraumatologyAnkara University Faculty of MedicineAnkaraTurkey

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