The clinical and radiological results of arthroscopic versus arthroscopy assisted mini-open repair of rotator cuff tears

Abstract

In this study we reported retrospectively the comperative clinical and radiological results of the two most common surgical procedures in rotator cuff tear repair of shoulder, the golden standart arthroscopic and alternative arthroscopically assisted mini-open surgery. We included 58 patients who admitted to our clinic for rotator cuff tear and treated surgically between january 2013 and august 2015. The two groups were composed of arthroscopically treated 29 patients and 29 patients who were treated with arthroscopically assisted mini open surgery. The arthroscopy group included 18 females and 11 males, the mini-open group included 10 females and 19 males. The mean age was 56,0 (39,0-73,0) years, in arthroscopic and 55,0 (40,0-70,0) years in mini-open surgery group. 6 patients in the arthroscopy group(20,7%) and 10 patients in the mini-open group(34,5%) were defining trauma before the beginning of their complaints. The postoperative follow up was 28,9 months in arthroscopy group and 22,6 months in the mini-open surgery group. Preoperative physical or medical treatments were documented. Any additional surgical procedures like biceps long head tenotomy, subacromial decompression and bursectomy were also noted. Patients were evaluated with ASES and Constant shoulder scales before and after the surgery. Patients were evaluated radiologically with MRI at the last follow up for healing and tendon quality. The type 2 acromion was the dominant in both groups constituting the 44,8% of the total number of patients. 24 (82,8%)patients in the arthroscopically treated patients and 18(62,1%) patients in the mini-open group were undergone at least one of the additional surgical treatments. The mean length of the surgical scar was 3,4(3-5) cm in mini open group. None of the patients complained of the surgical scar. 16 patients in the arthroscopy group and 17 patients in the mini-open group had supraspinatus tendon pathology(either tear or degeneration) in the MRI control at the last follow up. Postoperative pain was present in 1 patient in each group who were classified as bad result. There was no statistically meaningful difference between two groups in terms of clinical or radiological results. In conclusion the arthroscopy assisted mini-open surgery may be a useful tool in hands of training surgeons to prevent ineffective treatment of rotator cuff tears.