The Relevance of Open Rotator Cuff Repair in 2021.

BACKGROUND: The last decade has seen a large increase in rotator cuff surgery and arthroscopic surgery. We were asked to define the relevance of open rotator cuff repair in 2021.
PURPOSE: To define whether there are proven advantages to arthroscopic or open rotator cuff repair surgery.
METHOD: We reviewed the recent literature regarding recent trends, anaesthetic time, rehabilitation, post-operative pain, complications, economic considerations, the learning curve and outcomes. We outlined the senior authors' technique preferences, rationale and patient reported outcomes.
RESULTS: There is no clear evidence of proven advantage in arthroscopic rotator cuff repair compared to open rotator cuff repairs, with regard to outcomes or the other aspects reviewed. There were no differences in the outcomes of arthroscopic and open repairs in the senior authors practice with his procedure indications.
CONCLUSIONS: Open rotator cuff repair surgery remains a valid option and has some appeal in specific indications and in settings where arthroscopic resources are limited. We believe surgeons should learn both techniques and the principles of good patient selection, tissue handling, and fixation techniques are of paramount importance in both arthroscopic and open rotator cuff surgery. © Indian Orthopaedics Association 2021.