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Clinical Orthopaedics and Related Research

, Volume 467, Issue 4, pp 966–978 | Cite as

Open versus Two Forms of Arthroscopic Rotator Cuff Repair

  • Neal L. Millar
  • Xiao Wu
  • Robyn Tantau
  • Elizabeth Silverstone
  • George A. C. Murrell
Original Article

Abstract

There have been technologic advances in the methods for repairing torn rotator cuffs. We compared the clinical and structural outcomes of three different forms of rotator cuff repair with up to 24 months’ followup. We wished to assess how surgical technique affected clinical outcomes and see how these correlated to repair integrity. Three cohorts of patients had repair of a symptomatic rotator cuff tear using (1) an open technique (n = 49); (2) arthroscopic knotted (n = 53); or (3) arthroscopic knotless (n = 57) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained preoperatively and at 6 weeks, 3 and 6 months, and 2 years postoperatively. Ultrasound studies were performed with a validated protocol at 6 months and 2 years postsurgery. Clinical outcomes were similar with the exception that the arthroscopic groups had, on average, 20% better American Shoulder and Elbow Surgeons scores than the open group at 6 months and 2 years. Retear correlated with tear size and operation time and occurred more frequently after open repair (39%) than after arthroscopic knotted (25%) and arthroscopic knotless (16%) repair. An intact cuff on ultrasound corresponded to better results for supraspinatus strength, patient outcomes, and rotator cuff functional ability.

Level of Evidence: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Rotator Cuff Rotator Cuff Tear Rotator Cuff Repair Arthroscopic Technique Arthroscopic Repair 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank SN Jeanette Marshall and SN Belinda Bosley for assistance with clinical examination and data collection.

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Copyright information

© The Association of Bone and Joint Surgeons 2009

Authors and Affiliations

  • Neal L. Millar
    • 1
    • 2
  • Xiao Wu
    • 1
  • Robyn Tantau
    • 3
  • Elizabeth Silverstone
    • 3
  • George A. C. Murrell
    • 1
  1. 1.Department of Orthopaedic Surgery, Orthopaedic Research Institute, St George Hospital CampusUniversity of New South WalesSydneyAustralia
  2. 2.Division of Immunology, Infection and Inflammation, Glasgow Biomedical Research CentreUniversity of GlasgowGlasgowUK
  3. 3.Department of Medical ImagingSt Vincent’s HospitalSydneyAustralia

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