All-arthroscopic versus mini-open double row rotator cuff repair - A prospective randomised control study based on functional and radiological outcomes

J Orthop. 2024 Jan 10:51:27-31. doi: 10.1016/j.jor.2024.01.005. eCollection 2024 May.

Abstract

Purpose: In an era where arthroscopic rotator cuff repair is dominant in the United States (77.9 % preference) compared to open surgery (53.33 %), a shift towards minimally invasive All-Arthroscopic (AA) techniques over classical Mini-Open (MO) repair is emerging. This study explores current trends in shoulder procedures in India and compares functional outcomes and radiological repair integrity between AA and MO techniques, which are understudied in the Indian context.

Methodology: In this prospective study, 60 patients (30 in the AA group and 30 in the MO group) with rotator cuff tears underwent assessment. Pre/post-operative clinical evaluations and 12-month follow-ups using UCLA and Oxford Shoulder Score, along with preoperative MRI and postoperative USG, were conducted.

Results: At one-year follow-up, the AA group showed better functional outcomes (53.3 % excellent/good vs. 30.0 % in MO). No significant radiological differences (Sugaya grading) were found. Tear size was comparable with no association with functional/radiological outcomes.

Conclusion: The AA group demonstrated favourable functional outcomes, matched to MO group findings, which is in accordance with global studies. Despite higher costs, the increasing popularity of AA in India is justified by enhanced results and reduced postoperative discomfort.

Keywords: Arthroscopic repair; Functional outcomes; Mini-open; Radiological healing; Rotator cuff; Rotator cuff repair; Shoulder arthroscopy.