Cuff integrity after arthroscopic versus open rotator cuff repair: A prospective study
Arthroscopic rotator cuff repair (RCR) has been reported to have good clinical results but high retear rates by ultrasound. We prospectively assessed postoperative cuff integrity and outcome after arthroscopic RCR (40 patients) and compared these results with open RCR (32 patients). Evaluation preoperatively and at 1 year included a physical examination and magnetic resonance imaging. American Shoulder and Elbow Surgeons and Constant scores improved significantly in both groups (P < .0001). Overall, 69% of repairs in the open group and 53% in the arthroscopic group were intact by magnetic resonance imaging. Of tears less than 3 cm in size, 74% in the open group and 84% in the arthroscopic group were intact. Of tears greater than 3 cm in size, 62% in the open group and 24% in the arthroscopic group were intact (P < .036). In the arthroscopic group, patients with an intact cuff had significantly greater strength of elevation (P = .01) and external rotation (P = .02). We conclude that open and arthroscopic RCRs have similar clinical outcomes. Cuff integrity is comparable for small tears, but large tears have twice the retear rate after arthroscopic repair.
aColumbus Bone, Joint & Hand Surgeons, Inc, Columbus, OH, USA
bMontana Orthopedics and Sports Medicine, St Vincent’s Hospital, Billings, MT, USA
cArthroscopic and Reconstructive Shoulder Surgery Service, Faculty of Medicine, University of Calgary, Calgary, Alberta, Canada
dLeni and Peter W. May Department of Orthopaedics, Mount Sinai Hospital, New York, NY, USA
Reprint requests: Evan L. Flatow, MD, 5 E 98th St, Box 1188, Mount Sinai Medical Center, Department of Orthopaedic Surgery, New York, NY 10029.
Supported in part by a Prospective Clinical Research Grant from the Orthopaedic Research and Education Foundation (primary investigator, Evan L. Flatow, MD; 1996-1998; “Surgical repair of the torn rotator cuff tendon: a prospective analysis of function, quality of life, costs and factors that affect these analyses”) and by an Imaging Core Award from the National Institutes of Health and General Clinical Research Center, Mount Sinai Medical Center (primary investigator, Evan L. Flatow, MD).
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