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This Article Full Text Full Text (PDF) All Versions of this Article: 36/6/1043    most recent 0363546508314409v2 0363546508314409v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Google Scholar Articles by Mohtadi, N. G. Articles by Li, F. X. PubMed PubMed Citation Articles by Mohtadi, N. G. Articles by Li, F. X. Related Collections Shoulder Arthroscopy

A Randomized Clinical Trial Comparing Open to Arthroscopic Acromioplasty With Mini-Open Rotator Cuff Repair for Full-Thickness Rotator Cuff Tears

Disease-Specific Quality of Life Outcome at an Average 2-Year Follow-Up

Nicholas G. Mohtadi, MD, FRCSC^,*, Robert M. Hollinshead, MD, FRCSC, Treny M. Sasyniuk, MSc, Jennifer A. Fletcher, MD, FRCSC, Denise S. Chan, MBT and Feng X. Li, MD, PhD

From the University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada, Saint John Regional Hospital, Saint John, New Brunswick, Canada, and the Division of Population Health and Information, Alberta Cancer Board, Edmonton, Alberta, Canada

^* Address correspondence to Dr Nicholas Mohtadi, University of Calgary Sport Medicine Centre, 2500 University Drive NW, Calgary, Alberta, Canada T2N 1N4 (e-mail: mohtadi{at}ucalgary.ca).

Background: Rotator cuff tears affect patients’ quality of life. The evolution toward less invasive operative techniques for rotator cuff repair requires appropriate comparisons with the standard open procedure, using validated outcomes in a randomized fashion.

Hypothesis: There is no difference in disease-specific quality of life outcomes at 2 years between an open surgical repair (open) versus an arthroscopic acromioplasty with mini-open (scope mini-open) repair for patients with full-thickness rotator cuff tears.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: Patients with unremitting pain, failed nonoperative treatment, and imaging indicating full-thickness rotator cuff tears were included in the study. Massive irreparable cuff tears were excluded. Patients were assessed using the disease-specific Rotator Cuff-Quality of Life index, which produces a maximum score of 100, representing a high quality of life. Secondary shoulder-specific outcomes (American Shoulder and Elbow Society, Shoulder Rating Questionnaire, and Functional Shoulder Elevation Test) were also measured at baseline, 3 and 6 months, and 1 and 2 years.

Results: The mean Rotator Cuff-Quality of Life scores at an average follow-up of 28 months were not statistically different: open, 86.9 (95% confidence interval: 81.8–92.0); and scope mini-open, 87.2 (95% confidence interval: 80.6–93.8). At 3 months, the patients who underwent scope mini-open showed statistically significantly better outcomes (55.6 vs 71.3; P = .005). The baseline to 3-month difference in Rotator Cuff-Quality of Life scores between the scope mini-open and open groups was also statistically significant.

Conclusion: Patient outcomes improved from baseline to all postoperative measurement intervals. There was no difference in outcome at 1 and 2 years after surgery between the scope mini-open and open procedures. The quality of life of patients undergoing the arthroscopic acromioplasty with mini-open rotator cuff repair improved statistically significantly and clinically at 3 months compared with the open group.

Key Words: rotator cuff • open acromioplasty • arthroscopic mini-open • quality of life