Jon J P Warner1, Patrice Tétreault, Janne Lehtinen, David Zurakowski. 1. Harvard Shoulder Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114, USA. jwarner@partners.org
Abstract
PURPOSE: To critically compare arthroscopic and mini-open rotator cuff repair. TYPE OF STUDY: Retrospective case control study. METHODS: Nine patients who had an arthroscopic rotator cuff repair (ARCR) were matched for age, gender, dominance, side of injury, history of trauma, duration of symptoms, and type of rotator cuff injury, with 12 patients who had a mini-open rotator cuff repair (MOR). Comparison included a preoperative and postoperative physical examination as well as a completed Simple Shoulder Test (SST) questionnaire at the latest follow-up at a minimum of 27 months. RESULTS: Both groups had significant reductions in pain scores (P < .01) and there was no significant difference in preoperative or postoperative active flexion or external rotation between both groups (P > .20). Although the ARCR group showed a significant improvement in strength (P < .01) and the MOR group did not, no patient had less than 4/5 strength. The impingement sign remained positive in 1 MOR patient, but all patients had a negative Jobe's test result. Pain and Tasks assessment by SST questionnaire showed that neither group had night pain or discomfort when using their arms overhead. There were no significant differences in the overall SST scores between groups. CONCLUSIONS: Because all patients in each group were satisfied with the procedure and there were no objective differences in outcome, we conclude that there is no difference in outcome between ARCR and MOR. Thus, the choice of one approach over the other is best based on surgeon or patient preference. LEVEL OF EVIDENCE: Level III, Retrospective Case Control Study.
PURPOSE: To critically compare arthroscopic and mini-open rotator cuff repair. TYPE OF STUDY: Retrospective case control study. METHODS: Nine patients who had an arthroscopic rotator cuff repair (ARCR) were matched for age, gender, dominance, side of injury, history of trauma, duration of symptoms, and type of rotator cuff injury, with 12 patients who had a mini-open rotator cuff repair (MOR). Comparison included a preoperative and postoperative physical examination as well as a completed Simple Shoulder Test (SST) questionnaire at the latest follow-up at a minimum of 27 months. RESULTS: Both groups had significant reductions in pain scores (P < .01) and there was no significant difference in preoperative or postoperative active flexion or external rotation between both groups (P > .20). Although the ARCR group showed a significant improvement in strength (P < .01) and the MOR group did not, no patient had less than 4/5 strength. The impingement sign remained positive in 1 MOR patient, but all patients had a negative Jobe's test result. Pain and Tasks assessment by SST questionnaire showed that neither group had night pain or discomfort when using their arms overhead. There were no significant differences in the overall SST scores between groups. CONCLUSIONS: Because all patients in each group were satisfied with the procedure and there were no objective differences in outcome, we conclude that there is no difference in outcome between ARCR and MOR. Thus, the choice of one approach over the other is best based on surgeon or patient preference. LEVEL OF EVIDENCE: Level III, Retrospective Case Control Study.
Authors: Giuseppe Milano; Andrea Grasso; Donatella Zarelli; Laura Deriu; Mario Cillo; Carlo Fabbriciani Journal: Knee Surg Sports Traumatol Arthrosc Date: 2007-08-08 Impact factor: 4.342
Authors: Philip Kasten; Christoph Keil; Thomas Grieser; Patric Raiss; Nikolaus Streich; Markus Loew Journal: Int Orthop Date: 2011-04-30 Impact factor: 3.075