Rotator Cuff Repair: Open vs Arthroscopic - Manoj Ramachandran 14/11/2000

- Most literature on full thickness tears (FT-RCT)

- REMEMBER GARY GARTSMAN and HARVARD ELLMAN

- Treatment shift through 3 phases open, combined open and arthroscopic (=mini-open) and arthroscopic alone

- >15 years experience with arthroscopy leading to following conclusions:

- Smaller skin incision, decreased length of hospital stay

- Access to glenohumeral joint for intraarticular lesion Dx and Rx

- No need to detach deltoid and less soft-tissue dissection

- ?increased rotatory ROM

!!  Technical difficulty, problems during learning curve still in developmental stage

1

Author HAWKINS , Misamore et al. ( LONDON, CANADA)
Title Surgery for full-thickness rotator-cuff tears
Reference 1985 JBJS-Am, Vol 67(9): 1349-1355
Summary Retrospective review of 100 consecutive patients with FT-RCT tretaed by direct suture or attachment of medial edge to humerus (McLaughlin procedure), plus anterior acromioplasty (Neer procedure) showing relief of pain (86%) regardless of tear size, increased flexion and abduction (but not rotation) and recovery of strength related to tear size
Critique Mixed indications, surgical technique change, 30 patients compensation

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