All-arthroscopic versus mini-open rotator cuff repair: long-term follow-up (SS-10)

      All arthroscopic repair has previously been shown to show equivalent short-term outcome and decreased morbidity compared to mini-open repair. Concerns have remained however about both the technical difficulty and long-term outcome of all-arthroscopic repair. From 1/96 to 3/99 501 patients were the subjects of an earlier report in 2000 on the preliminary results contrasting all arthroscopic repair and mini open repair. Two hundred twenty one of these had moderate or large tears or other diagnoses and were excluded, leaving 280 patients for review. 126 chose an all-arthroscopic repair versus 154 with an open repair. These patients were re-reviewed four years later to form the basis of this study. Follow-up averaged 84.3 months for the arthroscopic and 95.8 for open with a minimum of six years. Age, gender, associated findings at surgery, and duration of surgery were not significantly different between the two groups. There were two manipulations and two reoperations for failed repair in the open group (3%) in the early study; one additional repair in the open group failed at longer follow-up. One patient had a loose anchor (1%) using second-generation anchors and better technique. Two patients had early failed repairs and an additional two failed later with a total reoperation rate of 4% (p = ns). Final outcomes as measured by ASES, UCLA and SST scores were not statistically different. All arthroscopic repair is shown to offer a significant reduction in perioperative morbidity over mini open repair. Mid-range follow-up continues to show equivalent outcomes between the two techniques. While the anatomic outcome of the two techniques at mid to long-term follow-up remains unknown, clinical results between the two techniques remains the same.