Better early improvements in pain from arthroscopic vs. mini-open rotator cuff repairs

Both arthroscopic and mini-open rotator cuff repairs yielded similar improvements in function at 6 months follow-up.

Both arthroscopic and mini-open rotator cuff repair techniques result in similar early functional improvement in patients treated for small and medium tears, a retrospective study found. However, patients treated arthroscopically had significantly less pain up to 6 months postop, the study authors noted.

"In our retrospective study, we found that the early functional outcomes of [mini-open rotator cuff repair] and [arthroscopic rotator cuff repair] of small- and medium-sized rotator cuff tears are nearly equivalent," the authors reported in the study, published in the journal Arthroscopy.

"However, an equally important result ... was the finding that [arthroscopic repairs] was associated with statistically significant improvement in the 3-month SF-36 (Short Form-36) bodily pain score and the 6-month VAS (Visual Analog Scale) pain score. Future randomized controlled trials may provide additional data that distinguish advantages of one technique over the other," the authors wrote.

Lana Kang, MD, and colleagues conducted the retrospective study, which included 128 patients — 63 patients underwent a mini-open repair and 65 underwent an arthroscopic repair.

Both patient groups were demographically similar. Patients included in the mini-open group had slightly larger tears, which averaged 1.8 cm vs. 1.6 cm for the arthroscopic repair group. However, "the maximal tear size did not exceed 2.2 cm in either group," the authors wrote, noting that tear widths were similar for both groups.

The researchers found that all patients showed improvements in pain medication use, Simple Shoulder Test scores, all VAS scores, Disabilities of the Arm, Shoulder and Hand scores, and numerous SF-36 subscores at 3 months postop. Patients also showed significant improvements in active forward elevation and elevation strength, according to the study.

"The SF-36 score for bodily pain was the only outcome parameter for which there was a statistically significant difference," the authors noted.

At 3 months follow-up, SF-36 bodily pain scores improved an average of 12.87 points for patients in the mini-open group and improved an average of 22.84 points for the arthroscopic group, according to the study.

"At 6 months postoperatively, the improvement in the VAS score for pain was statistically significant in favor of the [arthroscopic repair] group, with a change of 4.4, versus a change of 3.3 in the [mini-open repair] group," the authors wrote.

For more information:
Kang L, Henn RF, Tashjian RZ, Green A. Early outcomes of arthroscopic rotator cuff repair: A matched comparison with mini-open rotator cuff repair. Arthroscopy. 2007;23:573-582.