Minimally Invasive Arthroscopic Procedures for Rotator Cuff Repair
Arthroscopy offers significant advantages over open surgery in rotator cuff repair.
Minimally invasive techniques reduce post-operative pain and speed up recovery.
Functional results are comparable between arthroscopy and open surgery.
The use of arthroscopic techniques is increasing, and today represents the "gold standard"
Gabriele February
4 min. Feb 15, 2025
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Minimally Invasive Arthroscopic Procedures for Rotator Cuff Repair
TL:DR:
Arthroscopy offers significant advantages over open surgery in rotator cuff repair.
- Minimally invasive techniques reduce post-operative pain and speed up recovery.
- Functional results are comparable between arthroscopy and open surgery.
- The use of arthroscopic techniques is increasing, with promising success rates.
The "Gold Standard" in Shoulder Surgery
Rotator cuff repair is one of the most common surgical procedures for treating shoulder injuries. In recent years, the arthroscopic approach has gained popularity over open surgery due to its numerous advantages. This article will explore minimally invasive techniques for rotator cuff repair, comparing the results and clinical implications with open surgery.
The Importance of the Rotator Cuff
The rotator cuff is a group of muscles and tendons that stabilize and move the shoulder joint. Injuries to this structure can cause pain, weakness, and limited movement, significantly impacting quality of life. Surgical repair is often necessary when conservative treatments are ineffective.
Surgical Techniques: Arthroscopic vs. Open
Traditionally, rotator cuff repair was performed through an open incision, which resulted in greater tissue trauma and a longer recovery. However, the advent of arthroscopic surgery has revolutionized this approach. Arthroscopic techniques use small incisions and specialized instruments to repair damaged tendons, reducing postoperative pain and speeding recovery. Arthroscopic rotator cuff repair represents a significant advancement in orthopedic surgery. This minimally invasive procedure allows the surgeon to operate on the shoulder using generally two to four small incisions, each approximately 0.5–1 cm. Specialized instruments and a video camera are inserted through these small incisions, thus reducing tissue trauma compared to open surgery.
Advantages of the Arthroscopic Approach
- Minor Tissue Trauma: Arthroscopy reduces damage to the surrounding muscles and tendons, preserving the function of the rotator cuff.
- Faster Recovery: Patients who undergo arthroscopic surgery tend to recover more quickly, returning to normal daily activities sooner.
- Less Post-Operative Pain: Minimally invasive techniques are associated with less postoperative pain than open surgery, improving the overall patient experience.
Clinical Results and Scientific Evidence
Numerous studies and systematic reviews have compared the outcomes of arthroscopic and open techniques. For example, a meta-analysis demonstrated that, although there are differences in recovery times and pain, functional outcomes, such as the American Shoulder and Elbow Surgeons (ASES) score, are comparable between the two approaches. Furthermore, the analysis highlighted that arthroscopic techniques can lead to re-tear rates similar to those of open surgery, but with a significant improvement in postoperative quality of life.
The choice between arthroscopic and open surgery for rotator cuff repair depends on several factors, including the severity of the injury, the patient's age, and the surgeon's preference. However, evidence suggests that the arthroscopic approach offers significant advantages in terms of less invasiveness and faster recovery, making it a preferred option for many patients.
Useful Resources
- Dr. Gabriele Vasario, Shoulder Orthopedist, Turin
- Other Content and News on Shoulder Surgery
- Other Content and News on Shoulder Surgery and the Rotator Cuff
- Patient Resources
- Finding scientific answers autonomously with artificial intelligence
- Search for scientific answers independently in the world's largest database
- SICSeG (Italian Society of Shoulder and Elbow Surgery)
Bibliography
- Kholinne E., Jeon I. "Open Rotator Cuff Repair: Where Does it Stand Now?" Orthopaedic Journal of Sports Medicine, 2019.
- Burkhead W., Moen T., Rudolph G. "General surgical principles of open rotator cuff repair in the management of failed arthroscopic cuff repairs." Instructional Course Lectures, 2013.
- Yamaguchi K., Ball C., Galatz L. "Arthroscopic Rotator Cuff Repair: Transition From Mini-Open to All-Arthroscopic." Clinical Orthopaedics and Related Research, 2001.
- MacDonald P., Altamimi S. "Principles of arthroscopic repair of large and massive rotator cuff tears." Instructional Course Lectures, 2010.
- McCluskey G., Gaunt B. "Mini-open rotator cuff repair." Journal of Surgical Orthopaedic Advances, 2006.
- Yadav H., Nho S., Romeo A., Macgillivray J. "Rotator cuff tears: pathology and repair." Knee Surgery, Sports Traumatology, Arthroscopy, 2009.
- Sharma D., Tolani M., Pathan S., Soni S., Patel D.R., Shroff M.R. "A Comparative Analysis of Functional Recovery in Surgical Rotator Cuff Tear Repair: Mini-Open Versus All-Arthroscopic Techniques." Cureus, 2024.
- Khosla N., Garg R., Mahindra P. "To determine shoulder function after arthroscopic rotator cuff repair using university of California and Los Angeles score." Indian Journal of Orthopaedics Surgery, 2022.