Mini-Open Rotator Cuff Repair

Abstract

Rotator cuff tears have long been recognized as a disabling problem of the upper extremity. Codman reportedly performed the first open rotator cuff repair in 1911.1 However, it was not until 1972 when Neer reported the results of anterior acromioplasty in combination with cuff mobilization and repair that results substantially improved.2 The surgical fundamentals detailed by Neer significantly improved the reliability and outcome of the surgery. These principles include the preservation or meticulous repair of the deltoid origin, adequate decompression of the subacromial space, adequate mobilization of the rotator cuff tendons with release of adhesions, secure fixation of the tendon to bone, and a closely supervised rehabilitation program.3 Traditional open methods of rotator cuff repair have achieved good results because of these basic fundamental principles.4–8 Neer reported on 233 rotator cuff repairs in 1988. In this series he reported that 91% resulted in an excellent or satisfactory rating.8 Hawkins similarly reported on 100 patients. He reported that 86% of patients had no or slight pain.7 However, the risks of postoperative stiffness, possible deltoid detachment, an inability to accurately diagnose and treat articular pathology, and significant postoperative pain continue to pose difficult problems.