Comparison of clinical and radiological outcomes of all arthroscopic versus mini-open rotator cuff tear repair

BACKGROUND: Rotator cuff tears are one of the most common causes of shoulder joint pain and dysfunction. The current study aimed Clinical and radiologic comparison of arthroscopy assisted mini open and arthroscopic repair methods for reduction of intentional pain, recovery of muscle strength and functions. METHODS: Forty patients who underwent a repair of full-thickness rotator cuff rupture in the Orthopedic and Traumatology Deparment of Sakarya University between 2014 and 2016 were retrospectively reviewed. Patients were divided into 2 groups and 15 out of 40 were treated with mini-open and 25 patients with arthroscopic method. Age, gender, surgical intervention, pre and post surgical examination findings, Constant Murley and UCLA scores, radiological imaging findings were evaluated. Clinical and radiological results of arthroscopy assisted mini open method and arthroscopic method were studied both in their own groups and comparatively. RESULTS: Our first study group, called group 1, who had arthroscopy assisted mini open method, included 15 patients, 4 males and 11 females. The mean age was 57,4 (range 37-75). According to UCLA score, preoperative score was a mean of 10.93 (range 8-14) and postoperative mean was 32,46 (range 27-35). According to Constant Murley scoring, preoperative score was a mean of 31,6 (range 25-45), postoperative was 88,13 (range 77-94). Our second study group, called as group 2, who underwent arthroscopic repair and included 25 patients, 9 males and 16 females. The mean age was 53,1 (range 41-69). According to UCLA score, preoperative mean score was 11,12 (range 9-14), postoperative mean score was 31,16 (range 18-35). According to Constant Murley scoring mean preoperative and postoperative scores were 31 (range 23-40) and 87,48 (range 68 to 94) respectively. Radiological classification were evaluated according to muscular atrophy and fatty degenaration, which described by Thomazeau. 11 patients were grade1, 25 patients were grade 2 and 4 patients were grade 3. In our study, there was no increase at the level of fatty degeneration and atrophy in patients with intact tendon integrity, an increase of 3 in 3 of 6 patients were evaluated as tears. Postoperative physical examination, radiological and subjective evaluation of the patients showed significant improvement in both groups compared to the preoperative level. p value was accepted as meaningful when it is <0.05 and in comparison of pre and postoperative groups, p was <0,0001 and this signify a meaningful difference. The other statistical values such as p was 0,356 for UCLA scoring and 0,94 for Constant scoring. When the physical examination, radiological and subjective data of both methods were compared, no significant difference was found between the two methods. CONCLUSION: Both arthroscopy assisted mini-open and arthroscopic methods are clinically and radiologically successful in the treatment of rotator cuff tears in our study. There was no significant difference in pain, functional capacity, range of motion, strength scores and satisfaction rates of both methods. These results suggest that both approaches may be appropriate approaches for orthopedists who have acquired the necessary experience.