The study, “A Systematic Review of Long-term Clinical and Radiological Outcomes of Arthroscopic and Open/Mini-open Rotator Cuff Repairs,” was published online on February 18, 2022 in The American Journal of Sports Medicine.

In a comparison of long-term outcomes of arthroscopic and open/mini-open rotator cuff repair, a new study shows that both techniques lead to similar long-term outcomes.

“Arthroscopic rotator cuff repair has shown similar midterm functional results and retear rates as open/mini-open rotator cuff repair. A pooled analysis of long-term results of both techniques is yet missing,” the researchers wrote.

The team conducted a systematic review using the CENTRAL (Cochrane), MEDLINE (PubMed), and Embase databases. All studies that reported long-term clinical and radiographic outcomes of full-thickness arthroscopic rotator cuff repair and open/mini-open rotator cuff repair with a minimum follow-up of nine years were included.

Overall, 11 studies met the inclusion criteria: 5 studies on arthroscopic rotator cuff repair and 6 studies on open/mini-open rotator cuff repair. Five hundred and thirty-nine patients with 550 shoulders were analyzed in the review. Mean patient age was 56.3 years (range, 25-77).

The researchers reported that the mean preoperative absolute Constant Score and American Shoulder and Elbow Surgeons (ASES) shoulder score were significant improved postoperatively.

The retear rate was 41% (141 of 342 shoulders) without any between-group difference (arthroscopic Rotator Cuff Repair, 43%; open/mini-open rotator cuff repair, 39%; p = .364). A retear was associated with reduced absolute Constant Score as compared with a healed repair (p = .004).

“No significant differences were found in postoperative functional scores, complications, and retear rates after failed cuff repairs between the arthroscopic and open/mini-open repair groups,” the researchers wrote.

“Pooled analysis of arthroscopic and open rotator cuff repairs demonstrated sustained improvement in long-term shoulder scores and pain with a substantial retear rate in both groups, which was associated with inferior shoulder function. There were no significant differences in long-term functional outcomes, retear rates, and complications. Both surgical techniques may be used on the basis of factors such as patient or surgeon preference and cost. Further studies using a more robust randomized controlled trial or larger cohort design are recommended to ascertain whether one surgical repair technique is superior to the other.”