The purpose of this study was to assess the clinical outcomes of three different rotator cuff repair techniques and to correlate these results with the integrity of the cuff as determined by ultrasonographic evaluation.

Three cohorts of patients had repair of a symptomatic rotator cuff tear using:

an open technique with Mitek RC Quickanchor double row, one mattress suture per anchor (n = 49);

Standardised patient and examiner determined outcomes were obtained prospectively pre-operatively and at 6 weeks, 3 months and 6 months post-operatively. Ultrasound studies were performed with a validated protocol at 6 months post surgery.

Arthroscopic knotless repair was, on average,14 minutes faster than both open cuff repair (p< 0.001) and arthroscopic knotted repair (p< 0.01).Clinical outcomes were similar with the exception that the arthroscopic groups had, on average, 20% better ASES scores than the open group at 6 months (p< 0.001). The only complication was re-tear, which correlated with tear size (r=0.5, p< 0.001) and operation time (r=0.3, p< 0.001) and occurred more frequently following open repair (39%) compared with arthroscopic knotted (25%) and arthroscopic knotless (16%) repair (p< 0.01). The retear rates of tears > 8cm2 were significantly greater (p< 0.01) when using an open (88%) or arthroscopic knotted (67%) technique compared to the arthroscopic knotless (25%) cohort.

Rotator cuff repair, whether performed via an open or arthroscopic technique resulted in improvements in pain, motion, strength and function. An intact cuff on ultrasound corresponded to better results with regard to supraspinatus strength, patient outcomes and rotator cuff functional ability. Tears > 8cm2 fixed with an arthroscopic knotless technique had better structural outcomes at 6 months.