The temporal outcomes of open versus arthroscopic knotted and knotless rotator cuff repair over 5 years.

Shoulder Elbow

Orthopaedic Research Institute, Research & Education Centre, St George Hospital, Sydney, Australia.

Published: October 2015

AI Article Synopsis

  • The study evaluated the impact of different surgical repair techniques on the outcomes of rotator cuff surgery, specifically comparing open double-row repairs to two arthroscopic methods (single-row knotted and knotless).
  • Results showed that the open repair group had a significantly higher rate of retears (48%) at 5 years compared to the knotted (33%) and knotless (26%) arthroscopic groups, with factors such as age, tear size, and cuff strength influencing these outcomes.
  • Patients in the open repair group experienced increased pain and difficulties with overhead activities over the 5-year period, highlighting the superiority of arthroscopic techniques in terms of both structural integrity and clinical outcomes.

Article Abstract

Background: The present study aimed to determine how repair technique influenced structural and clinical outcomes at 5 years post-surgery.

Methods: Three cohorts of patients had repair of a symptomatic rotator cuff tear using (i) an open double-row mattress repair technique (n = 25); (ii) arthroscopic single-row simple suture knotted technique (n = 25); or (iii) arthroscopic single-row inverted mattress knotless technique (n = 36) by one surgeon. Standardized patient- and examiner-determined outcomes were obtained pre-operatively and postoperatively with a validated protocol, ultrasound were also performed at the same time.

Results: Retear occurred more often after open repair (48%) at 5 years than after arthroscopic knotted (33%) and arthroscopic knotless (26%) repair. Retear was associated with increasing age, pre-operative tear size and weaker pre-operative and 5 years postoperative cuff strength. Between 2 years and 5 years, the open repair group experienced an increase in the frequency of pain during activity, as well as in the difficulty experienced and the severity of pain during overhead activities (p < 0.05) and, at 5 years, also experienced more difficulty with overhead activities, compared to the arthroscopic knotless repair group.

Conclusions: At 5-year follow-up, arthroscopic rotator cuff repair techniques resulted in fewer retears and better outcomes compared to an open double-row technique.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4935122PMC
http://dx.doi.org/10.1177/1758573215581775DOI Listing

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