ROTATOR CUFF REPAIR: A RETROSPECTIVE STUDY COMPARING ARTHROSCOPIC VERSUS MINI- OPEN TECHNIQUE, 2 TO 4 YEARS POST-OPERATIVELY.

Abstract

Eighteen Arthroscopic and nine mini-open Rotator Cuff repairs were evaluated at an average of 31.5 months post-operatively. The tears were classified as small, moderate and massive with all the massive tears in the mini-open group. The arthroscopic group showed 94% patient satisfaction with the Western Ontario Rotator Cuff Index scale (WORC) of 89.6% and the University of California at Los Angeles (UCLA) score of 32.4/35. The mini-open technique showed 100% patient satisfaction, 83.7% with the WORC and 27.7/35 with the UCLA. This study showed both procedures were effective. It is one of the first to report on the use of the WORC index for evaluation.

The purpose of this study was to evaluate the mid term results of arthroscopic and mini-open (arthroscopic assisted) rotator cuff repairs using the Western Ontario Rotator Cuff Index (WORC) and the University of California at Los Angeles (UCLA) validated assessment systems.

Patients with classic rotator cuff tears were identified retrospectively and then seen for a one-time evaluation and scoring, using the WORC and UCLA index. The tears were classified as small- < 2 cm, moderate 2– 5 cm, and massive > 5cm.

27/33 (82%) responded, eighteen arthroscopic, nine mini-open with all the massive tears falling into the mini-open category. The average time frame from operation was 31.5 months, average age, 57.7 years. Overall results for the arthroscopic technique were, 94% (17/18) patient satisfaction, WORC 89.6%, UCLA 32.4/35. Overall result for the mini-open technique was 100% patient satisfaction, WORC 83.7%, UCLA 27.7/35. The size of the tear was found to be statistically significant only with respect to the degree of external rotation achieved at the final evaluation. WCB patients (three) showed a discrepancy between subjective and objective outcomes.

Arthroscopic and mini-open Rotator Cuff repairs are associated with a very high level of patient satisfaction, and high scores when evaluated by the WORC and UCLA indexes.

This study shows that arthroscopic, and mini-open repairs (for the massive tears), are very effective procedures. It is one of the first to utilize the WORC index for evaluation along with the UCLA which has been more commonly used.