Comparable clinical outcomes despite high re-tear rates: arthroscopic versus mini-open repair in small- to medium-sized rotator cuff tears.

Abstract

To compare the clinical, functional, and radiological outcomes of arthroscopic versus arthroscopy-assisted mini-open repair in patients with small-to-medium-sized full-thickness rotator cuff tears, with particular focus on the relationship between postoperative structural integrity and functional recovery. A prospective comparative cohort study was conducted including 53 patients treated between June 2015 and June 2018; 24 patients underwent AR and 29 underwent MOR. Only tears < 3 cm with Goutallier grade 0-1 fatty degeneration were included. Clinical and functional outcomes were evaluated preoperatively, at 6 months, and at final follow-up using the UCLA shoulder score, SF-36, and range of motion (ROM). Repair integrity was evaluated using magnetic resonance imaging at the 24-month follow-up according to the Sugaya classification system. Significant enhancements in UCLA scores, ROM parameters, and SF-36 domains were achieved by both cohorts at the 6-month and final follow-up assessments relative to baseline (p < 0.001). Inter-group comparisons revealed no statistically significant disparities at any evaluation interval (p > 0.05). No statistically significant difference was observed in structural failure rates between the groups (p = 0.942), with re-tear rates of 44.8% in the mini-open group and 45.8% in the arthroscopic group. Despite the relatively high structural failure rate, both groups demonstrated substantial clinical and functional improvement. These findings suggest that postoperative radiological integrity may not always correlate directly with functional recovery after rotator cuff repair.