Comment:
There has been a push toward arthroscopic treatment of rotator
cuff injuries. This article discusses arthroscopic
techniques as being as effective as the traditional open
methods in experienced hands.
The advantages of this method include better mobilisation and
release of the cuff, decreased surgical insult to the deltoid
muscle, less postoperative pain and stiffness, and the ability
to address larger tears with new techniques. However this is a technically demanding procedure
to perform arthroscopically and therefore an experienced,
appropriately trained Arthroscopic Shoulder Surgeon will
achieve best results with this technique.
Abstract: There has been much recent enthusiasm regarding complete
arthroscopic rotator cuff repair, and it is becoming apparent
that, for many, this newer technique may be a preferable
alternative to the more traditional mini-open rotator cuff
repair. Several short-term studies have demonstrated that
complete arthroscopic repair has excellent results comparable
with those of mini-open repair, which is also an excellent
technique. The choice of which procedure may be better for an
individual patient or surgeon can be based on a variety of
considerations, including the patient's expectations, the
pathoanatomy of the cuff, and the surgical experience of the
surgeon. The relative merits and disadvantages of arthroscopic
rotator cuff repair are discussed on the basis of those
considerations. When a surgeon is deciding which procedure to
perform, it is important that the basic principles of rotator
cuff repair not be compromised and that he or she perform the
procedure that is most reproducible given his or her level of
experience; however, for those who are now utilizing miniopen
repair, arthroscopic repair may have important advantages and
may be worth pursuing in the future. If a surgeon chooses to
obtain the skills necessary to perform a complete arthroscopic
repair, performance of the mini-open procedure offers an
excellent opportunity to make an orderly transition.
