Role of biomechanical assessment in rotator cuff tear repair: Arthroscopic vs mini-open approach

Abstract

BACKGROUND Rotator cuff (RC) tears are one of the most frequent pathologies within the shoulder girdle. Hand dominance and older age are associated with RC tears. Two different surgical procedures, the mini-open (MO) and all-arthroscopic (AA) approach, represented the standard of treatment. AIM To compare the clinical and biomechanical outcomes of two surgical techniques (AA vs MO procedure) performed to address the painful shoulder syndrome with partial or total supraspinatus tendon tear. METHODS Eighty-eight participants, 50 following RC repair with AA and 38 with MO approach, were recruited in the present cross-sectional case-control study (ORTHO-SHOULDER, Prot. 0054602). All patients underwent postoperative clinical evaluation for pain (Visual analogic scale), impairment, and disability (disability of the arm, shoulder, and hand) and limitation in daily activity (Constant-Murley score). Patients’ shoulder mobility was also assessed in our Laboratory of Functional Movement through a wearable inertial sensor and surface electromyography to monitor kinematics and muscle activity during the movement on the frontal (abduction/adduction) and sagittal (flexion-extension) planes. RESULTS No statistically significant differences between the two procedures were observed in either main clinical score or range of motion. A significant increase in velocity during the movement execution and a higher contribution of upper trapezius muscles were found in the AA group compared with MO patients. CONCLUSION In terms of clinical scores, our findings were in line with previous results. However, the use of technology-based assessment of shoulder mobility has revealed significant differences between the two techniques in terms of mean velocity and pattern of muscle activation.

Two-Stage Exchange Arthroplasty for Periprosthetic Reverse Shoulder Arthroplasty Infection Provides Comparable Functional Outcomes to Primary Reverse Shoulder Arthroplasty

“…However, it is the author's opinion that what matters for patients is ultimately to improve function and solve pain issues as opposed to the length of the reconstruction process. In the future, it could be interesting to assess functional outcomes more objectively through in vivo biomechanical analysis [25].…”

Comparison of Outcomes between Open and Arthroscopic Rotator Cuff Repair

“…Recent literature elucidates the role of arthroscopic intervention in these complex scenarios, providing a nuanced understanding of its indications and outcomes [ 21 ]. Especially when we evaluate the differences between open and arthroscopic surgeries in patients who underwent acromioplasty, we generally see better outcomes with open surgery.…”

Functional Outcomes of Mini-Open Rotator Cuff Repair Surgery: Retrospective, Observational Study

“…Therefore, it warrants early diagnosis and proper treatment. [1] Rotator cuff tears may present with a variety of clinical features including debilitating shoulder pain and decreased range of motion. The objective of rotator cuff repair is to alleviate pain and improve function and strength of the affected shoulder.…”

“…On the other hand, Arthroscopic technique is a newer skill with development of specialized surgical equipment. [1] The basic idea behind rotator cuff repair is to restore the anatomical foot print of the rotator cuff on the humerus. This principle governs the advances in recent years.…”