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Systematic Review of Arthroscopic Rotator Cuff Repair and Mini-Open Rotator Cuff Repair
Shane J. Nho, MD, MS; Michael K. Shindle, MD; Seth L. Sherman, MD; Kevin B. Freedman, MD, MSCE; Stephan Lyman, PhD; John D. MacGillivray, MD
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Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which the authors, or a member of their immediate families, are affiliated or associated.
Note: The authors thank Dr. Mark F. Sherman for contributing figures.

The Journal of Bone and Joint Surgery, Incorporated
J Bone Joint Surg Am, 2007 Oct 01;89(suppl 3):127-136. doi: 10.2106/JBJS.G.00583
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Rotator cuff repair is one of the most common surgical procedures performed in the shoulder, and the benefit of repair is well known1-5. Over the past decade, the treatment of rotator cuff tears has evolved from an open procedure to an arthroscopic-assisted (mini-open) technique to an all-arthroscopic technique. Traditional open rotator cuff repairs produce satisfactory results when used for the treatment of nonmassive tears (<5 cm). However, this procedure has been associated with morbidity such as severe early postoperative pain, deltoid detachment and/or weakness, and arthrofibrosis6-8. Mini-open repairs were developed because they had the potential advantage of less deltoid morbidity, and they have demonstrated results that have been similar to those of open repairs (Figs. 1-A through 1-D)9-14. With recent advances in arthroscopic techniques, many surgeons are now performing complete arthroscopic repairs. The potential advantages of this procedure include less pain, more rapid rehabilitation, the ability to treat intra-articular lesions, smaller skin incisions, less soft-tissue dissection, and an extremely low risk of deltoid detachment (Figs. 2-A through 2-E). In the short and long term, the arthroscopic approach has shown promising results3,7,15-27. Despite these advantages, the use of the complete arthroscopic repair is technically demanding and requires a large-volume practice in order for a surgeon to obtain proficiency in this procedure28. Because of the technical demands of this procedure, many orthopaedic surgeons still consider the mini-open repair to be the gold standard for rotator cuff repair29. We hypothesized that arthroscopic rotator cuff repair produces clinical results comparable with those of mini-open rotator cuff repair, with fewer complications.
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    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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