Mini-Open Rotator Cuff Repair: 15 Years Later

When rotator cuff repairs were first done using the mini-open technique back in 1993, surgeons didn’t really know how the results would turn out years down the road. Now with the data from this study, we have some 15-to 20-year outcomes to judge this technique by.

Seventy-nine (79) patients with shoulder pain, weakness, and impingement from a supraspinatus tendon tear were enrolled between 1993 and 1996. All had a tendon repair (stitching it back to the bone) and a subacromial decompression procedure by the same surgeon.

Subacromial decompression refers to shaving away some of the bone along the acromion to take pressure off the rotator cuff. The acromion is the curved piece of bone that comes from the scapula (shoulder blade) across the top of the shoulder. A mini-open (small incision) approach using an arthroscope was used to perform the surgeries.

Results were assessed using a special patient self-survey called the UCLA score. This simple but reliable tool measures patient satisfaction with the results after rotator cuff surgery based on function, active range of motion, strength, and pain. Everyone in the study completed the survey several times: first two years after surgery, then seven years later, and one final time (between 15 and 20 years).

The 79 patients ranged in ages from 49 to 92 years of age at the end of the study. As might be expected in a long-term study like this, some of the patients dropped out (or were dropped) from the study due to moving, dying, experiencing dementia or other cognitive impairment.

For the 49 patients in the study at the end, slightly more than two-thirds (69 per cent) felt they had good-to-excellent results. If only overall patient satisfaction was used as a measure (i.e., no one was dissatisfied), then 84 per cent thought the results were acceptable. Some patients did experience deterioration over time of the benefits they received and three had to have a reoperation. This is to be expected with an aging adult group.

The authors concluded that the mini-open rotator cuff repair technique does provide satisfactory short-, medium-, and long-term functional results for the majority of patients who have a reparable supraspinatus tendon tear. This is one of the first (and few) studies reporting on long-term outcomes (durability) for this procedure.