• Peer van der Zwaal, Bregje J W Thomassen, Marc J Nieuwenhuijse, Ruud Lindenburg, Jan-Willem A Swen, and Ewoud R A van Arkel.
• Department of Orthopaedic Surgery, Medical Center Haaglanden, The Hague, The Netherlands. peerzwaal@hotmail.com
• Arthroscopy. 2013 Feb 1;29(2):266-73.

PurposeThe purpose of this study was to compare clinical outcomes in the first postoperative year of patients with full-thickness small to medium-sized tears undergoing all-arthroscopic (AA) versus mini-open (MO) rotator cuff repair.MethodsOne hundred patients were randomized to either AA or MO rotator cuff repair at the time of surgery on an intention-to-treat basis. Patients were evaluated before and 6, 12, 26, and 52 weeks after surgery using the Disabilities of the Arm, Shoulder, and Hand (DASH) score as a primary outcome score and the Constant-Murley score, visual analog scale (VAS)-pain/impairment score, and measurement of active forward flexion/external rotation as secondary outcome measures. Ultrasound evaluation was used to assess structural integrity of the repair 1 year postoperatively.ResultsForty-seven patients were analyzed in the AA group and 48 in the MO group. Five patients were lost to follow-up. Mean age was 57.2 (SD 8.0) years in the AA group and 57.8 (SD 7.9) years in the MO group. Primary and secondary outcome measures significantly improved in both groups postoperatively. Overall mean primary and secondary postoperative outcome scores did not statistically significantly differ between the treatment groups (DASH between-group mean difference: -3.4; 95% confidence interval [CI], -10.2 to 3.4; P = .317). However, at the 6-week follow-up, DASH score, VAS-pain and -impairment, and active forward flexion were significantly more improved in the AA group than in the MO group. A retear was seen in 8 patients (17%) in the AA group and 6 patients (13%) in the MO group. Five patients in the AA group (11%) and 6 patients (13%) in the MO group developed adhesive capsulitis.ConclusionsFunctional outcome, pain, range of motion, and complications do not significantly differ between patients treated with all-arthroscopic repair and those treated with mini-open repair in the first year after surgery. Patients do attain the benefits of treatment somewhat sooner (6 weeks) with the arthroscopic procedure.Level Of EvidenceLevel II, randomized controlled trial without postoperative blinding.Copyright © 2013 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

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