[Arthroscopic-assisted mini-open rotator cuff repair]

Abstract

Objectives: New alternatives have been developed in rotator cuff repair with advances in arthroscopic techniques. We evaluated retrospectively the results of our patients who underwent arthroscopic-assisted mini-open rotator cuff repair.

Methods: Arthroscopic subacromial decompression and mini-open repair were performed in 31 patients (8 males, 23 females; mean age 54.3 years; range 38 to 71 years) with rotator cuff tear in which the tendon tear had not been excessively retracted (till glenoid) and the muscle had not undergone fatty degeneration. Patients below 40 years of age were considered for surgery, while those between 40 to 60 years were initially treated with a rehabilitation program to relieve pain and gain motion before surgery. Surgery was reserved until after failure with a three-month rehabilitation program in patients above 60 years. Evaluations were based on physical and radiographic examinations and Constant scores. The mean follow-up period was 24.4 months (range 12 to 37 months).

Results: Twenty-five patients (81%) achieved excellent or good results and six patients (19%) had satisfactory results. The mean Constant score was 84.6. One patient developed joint stiffness unresponsive to conservative treatment. Arthroscopic capsular release followed by a heavy exercise program enabled him to return to his former sports activity level within three months.

Conclusion: Arthroscopic-assisted repair is a superior alternative in rotator cuff surgery in selected cases because it enables the shoulder surgeon to preserve deltoid attachment and to prepare the torn tendon for an easy repair. It may result in shortened hospital stay, decreased postoperative pain, and an accelerated rehabilitation.