Extract
Rotator cuff repair is one of the most common surgical procedures performed
in the shoulder, and the benefit of repair is well
known1-5.
Over the past decade, the treatment of rotator cuff tears has evolved from an
open procedure to an arthroscopic-assisted (mini-open) technique to an
all-arthroscopic technique. Traditional open rotator cuff repairs produce
satisfactory results when used for the treatment of nonmassive tears (<5
cm). However, this procedure has been associated with morbidity such as severe
early postoperative pain, deltoid detachment and/or weakness, and
arthrofibrosis6-8.
Mini-open repairs were developed because they had the potential advantage of
less deltoid morbidity, and they have demonstrated results that have been
similar to those of open repairs (Figs. 1-A
through
1-D)9-14.
With recent advances in arthroscopic techniques, many surgeons are now
performing complete arthroscopic repairs. The potential advantages of this
procedure include less pain, more rapid rehabilitation, the ability to treat
intra-articular lesions, smaller skin incisions, less soft-tissue dissection,
and an extremely low risk of deltoid detachment
(Figs. 2-A through 2-E). In the
short and long term, the arthroscopic approach has shown promising
results3,7,15-27.
Despite these advantages, the use of the complete arthroscopic repair is
technically demanding and requires a large-volume practice in order for a
surgeon to obtain proficiency in this
procedure28.
Because of the technical demands of this procedure, many orthopaedic surgeons
still consider the mini-open repair to be the gold standard for rotator cuff
repair29. We
hypothesized that arthroscopic rotator cuff repair produces clinical results
comparable with those of mini-open rotator cuff repair, with fewer
complications.