Cuff Integrity Following Arthroscopic Versus Open Rotator Cuff Repair: A Prospective Study
Authors:
Julie Y. Bishop MD, Mount Sinai School of Medicine, New York, NY
Ian K. Lo MD, Mount Sinai School of Medicine, New York, NY
Steven J. Klepps MD, Yellowstone Medical Center, Billings, MT
Justin Bird, Mount Sinai School of Medicine, New York, NY
James N. Gladstone MD, Mount Sinai School of Medicine, New York, NY
Evan Flatow MD, Mount Sinai School of Medicine, New
York, NY
Objective: Arthroscopic rotator cuff repair (RCR) has been reported to have good clinical results but 70% to 90% retear rates by ultrasound. This study prospectively assesses postoperative cuff integrity and outcome following arthroscopic RCR, and compares these results to open RCR by the same surgeon.Methods: 52 consecutive patients undergoing arthroscopic RCR, by a single surgeon, were prospectively enrolled for evaluation preoperatively and at one-year follow up, including a postoperative MRI. This was a continuation of a prior prospective study of open RCR by the same surgeon.Results: There were 32 patients in the open RCR group and 32 patients have completed the arthroscopic RCR protocol. ASES scores improved from 53 to 80 in the open group and from 46 to 77 in the arthroscopic group, and Constant scores from 40 to 85 in the open group and from 52 to 71 in the arthroscopic group (all changes p<.05).
31% of the open and 53% of the arthroscopic group had retorn by MRI. Of tears <3cm, the retear rate was 26% in the open and 20% in the arthroscopic group. Of tears >3cm, the retear rate was 38% in the open and 82% in the arthroscopic group (p=0.034). There was a trend to better scores with an intact cuff (Constant 80, ASES 90) than with a retear (Constant 72, ASES 78). Patients with intact cuffs had significantly greater strength of elevation (p<0.005).Conclusions: Open and arthroscopic RCR had similar outcomes. Cuff integrity was comparable for small tears, but the retear rate for large tears was twice as high after arthroscopic repair.
