The joint will be examined and some parts of the repair or clean up may done as key hole surgery with the arthroscope. More commonly, the arthroscope is removed and the skin is cut to do a miniopen rotator cuff repair. Open surgery, miniopen surgery, or an arthroscopy might be necessary if your. The clinical outcomes of the surgical methods of rotator cuff repair open, mini open, and allarthroscopic cuff repair vary, as each method provides an array of advantages and disadvantages. This technique combines an arthroscopic subacromial decompression with an open tendon repair using a small deltoid split approach. In order to compare the miniopen and allarthroscopic.
Rehabilitation guidelines for type i and type ii rotator cuff. Mini open rotator cuff repair has been shown by several authors to provide predictable results similar to open repair. The mini open rotator cuff or arthroscopically assisted surgical procedure for repair of the rotator cuff has become a popular procedure with proven clinical results. Type two rotator cuff repair arthroscopic or miniopen medium to large tear greater than 1 cm and less than 5 cm i. Debridement of an acromial bone spur and removal of the inflammed bursa arthroscopic repair of your rotator cuff mini open repair of your rotator cuff deltoid splitting large open repair of your rotator cuff took down deltoid rotator cuff debridement. Anterolateral approach for miniopen rotator cuff repair ncbi. If the surgeon finds a torn rotator cuff tendon, the type of repair needed is based on the size and severity of the tear. The current study compared early postoperative outcomes between arthroscopic and mini open repair for rotator cuff tears of smaller than 3 cm to test the hypothesis that, of the 2 techniques.
Surgical repair of a rotator cuff tear can be done arthroscopically or with a mini open procedure. Surgical repair of a rotator cuff tear can be done arthroscopically or with a miniopen procedure. The goal of rotator cuff repair is to eliminate pain and improve function with increased shoulder strength and range of motion. Rehabilitation protocol for rotator cuff repair this protocol is intended to guide clinicians and patients through the postoperative course of a rotator cuff repair. The purpose of our study is to compare the functional results, isokinetic shoulder muscle strength and shoulder position sense of patients who have undergone allarthroscopic and miniopen surgery to repair their rotator cuff tears. Mini open rotator cuff surgery uses smaller incisions than open surgery, and the surgeon does not detach the large deltoid muscle. Mini open repair or arthroscopicassisted open rotator cuff repair is an arthroscopic subacromial decompression followed by an open repair through a deltoid splitting procedure, or the arthroscope may also be used to release adhesions and place tagging sutures with a mini open approach to obtain tendontobone fixation. More commonly, the arthroscope is removed and the skin is cut to do a mini open rotator cuff repair. Rotator cuff repair protocol boston shoulder institute. Two studies were excluded because the size of the tears were not reported26,56. Rotator cuff tears have long been recognized as a disabling problem of the upper extremity. Protocol s3 accelerated physical therapy protocol for. Jun 30, 2011 thus, the purpose of this study was to introduce the anterolateral approach for mini open rotator cuff repair and evaluate its clinical outcome and effectiveness.
Open surgery, mini open surgery, or an arthroscopy might be necessary if your. General time frames are given for reference to the average, but individual patients will progress at. Standard open or arthroscopic rotator cuff repair protocol. Recently, arthroscopic rotator cuff repair has been more popular, and satisfactory outcomes were reported by many authors 1, 57. The intent of this guideline is to provide both the patient and treating therapist with a framework of the postoperative rehabilitation course following arthroscopic assisted mini open rotator cuff repair. With advances in shoulder arthroscopy, repair techniques for rotator cuff tear have evolved from open techniques to arthroscopically assisted miniopen techniques and then to an allarthroscopic technique 14. A miniopen repair combines arthroscopy and the use of small incisions to treat fullthickness tears. Rotator cuff repair therapy protocol page 1 of 6 bart eastwood d. Allarthroscopic surgery and mini open surgery for repairing rotator cuff tears are widely used and clinically developed. Accelerated physical therapy protocol for rotator cuff repair arthroscopic or miniopen technique recommended for mild.
By using the arthroscope, the surgeon can also look into the shoulder joint to clean out any damaged tissue or bone spurs. There was no difference in outcome at 1 and 2 years after surgery between the scope miniopen and open procedures. The quality of life of patients undergoing the arthroscopic acromioplasty with mini open rotator cuff repair improved statistically significantly and clinically at 3 months compared with the open group. Pdf arthroscopicassisted miniopen rotator cuff repair. Next, a 1 to 5 inch incision is made to give the surgeon direct visual access to repair the tear. Arthroscopically assisted or miniopen repair has become a popular method of treating ful. Indications and implications for rehabilitation rotator cuff tears can lead to a variety of clinical manifestations, including debilitating shoulder dysfunction and impairment. Pdf this study was undertaken to introduce an anterolateral approach for miniopen rotator cuff repair and evaluate its clinical outcome and. Allarthroscopic surgery and miniopen surgery for repairing rotator cuff tears are widely used and clinically developed.
The mini open method of repairing a rotator cuff involves an arthroscopic portion of the surgery, and a short incision to get direct access to the torn rotator cuff tendon. Materials and methods between august 2006 and december 2008, 159 consecutive patients with rotator cuff tear underwent mini open repair by a single surgeon using an anterolateral. The mini open procedure is less invasive than the open. Suite 224a blacksburg, va 24060 54055273 all information contained in this protocol is to be used as general guidelines only. Early postoperative outcomes between arthroscopic and mini. Numerous surgical techniques and approaches have been described and established for the treatment of rotator cuff tears of the shoulder.
Phase i immediate postoperative phase weeks 0 6 days 014 patient is seen 2 days postoperative to remove surgical dressings and pain catheter. Rotator cuff repair therapy protocol sideline orthopedics. Indications and implications for rehabilitation r otator cu. Pdf this study was undertaken to introduce an anterolateral approach for mini open rotator cuff repair and evaluate its clinical outcome and. Rotator cuff tears have long been recognised as a cause of pain and disability. Arthroscopic rotator cuff repair frequently asked questions. To repair a torn rotator cuff, the tendons must be freed up from scar tissue and then sutured back down to the bone where they.
Specific changes in the program will be made by the physician as appropriate for an individual patient. Treating rotator cuff tears through a coracoacromial mini. Pdf allarthroscopic versus miniopen rotator cuff repair. Rotator cuff repair protocol south shore orthopedics. Miniopen rotator cuff surgery uses smaller incisions than open surgery, and the surgeon does not detach the large deltoid muscle. An alternative procedure for a fullthickness rotator cuff tear is with a combined procedure of arthroscopic subacromial decompression and miniopen repair, which has the po. Rotator cuff repair surgery can now be performed arthroscopically and is in most cases an outpatient day surgery procedure. The miniopen procedure is less invasive than the open.
Multiple studies have shown 80% to 88% of patients having good to excellent results at longterm followup. During mini open repair, any damaged tissue or bone spurs are removed or repaired using an arthroscope. The quality of life of patients undergoing the arthroscopic acromioplasty with miniopen rotator cuff repair improved statistically significantly and clinically at 3 months compared with the open group. The clinical outcomes of the surgical methods of rotator cuff repair open, miniopen, and allarthroscopic cuff repair vary, as each method provides an. Arthroscopicassisted miniopen rotator cuff repair article pdf available in acta orthopaedica et traumatologica turcica 361. The miniopen rotatorcuff repair technique developed as a less invasive method to treat rotatorcuff tear pathology. Arthroscopic decompression has more recently been combined with miniopen repair of the rotator cuff, which allows for the repair of the cuff without disruption of the deltoid origin.
Anterolateral approach for miniopen rotator cuff repair. Arthroscopic rotator cuff repair postoperative guidelines. The intent of this guideline is to provide both the patient and treating therapist with a framework of the postoperative rehabilitation course following arthroscopic assistedminiopen rotator cuff repair. Mini open repair uses both arthroscopic and open surgery techniques. Miniopen rotator cuff repair miniopen repair figure 4 figure 5 figure 6 figure 7 1. The majority of patients report improved shoulder strength and less pain after surgery for a torn rotator cuff. Arthroscopically assisted miniopen rotator cuff repair. Rotator cuff examined if no tear is found in the rotator cuff area, the procedure may end here. Rotator cuff repair with the juggerknot soft anchor 2. We hypothesized that arthroscopic rotator cuff repair produces clinical results comparable with those of miniopen rotator cuff repair, with fewer complications.
Most patients see improved shoulder function, as well as increased strength and range of motion. Rotator cuff repair surgery can restore use of the shoulder and reduce pain. Rotator cuff repair protocol the following procedures were performed. Mini open repair can give as good result as an arthroscopic repair approachaware of the position of axillary n. Mobilization of the rotator cuff if retracted, mobilize the rotator cuff by freeing it both superiorly and inferiorly in the planes medial to the. The primary goal of a rotator cuff repair is to restore the normal anatomy by approximating the rotator. Specific interventions should be based on the needs of the individual and should consider exam findings and clinical decision making. Open, miniopen, and allarthroscopic rotator cuff repair surgery. Miniopen repair uses both arthroscopic and open surgery techniques. Then during the open part of the surgery, a 2 to 3inch 5 to 7. During miniopen repair, any damaged tissue or bone spurs are removed or repaired using an arthroscope. A small size rotator cuff tear is defined as a tear repair is with an open acromioplasty procedure. Arthroscopically assisted or mini open repair has become a popular method of treating fullthickness tears of the rotator cuff.
Multisuture technique for open rotator cuff reconstruction. Each surgical repair technique open, miniopen, and arthroscopic has similar results in terms of pain relief, improvement in strength and function, and patient satisfaction. This means that it is very rare to have to spend the night in the hospital. Codman reportedly performed the first open rotator cuff repair in 1911. Open, miniopen, and allarthroscopic rotator cuff repair. The miniopen rotator cuff or arthroscopically assisted surgical procedure for repair of the rotator cuff has become a popular procedure with proven clinical results. The miniopen rotator cuff repair represents a bridge between open and arthroscopic rotator cuff repair. Arthroscopically assisted or miniopen repair has become a popular method of treating fullthickness tears of the rotator cuff.
Examine the tear from the various portals to determine tear type, configuration, and size, as well as amount of retraction. Anterolateral approach for mini open rotator cuff repair. With advances in shoulder arthroscopy, repair techniques for rotator cuff tear have evolved from open techniques to arthroscopically assisted mini. Miniopen repair can give as good result as an arthroscopic repair approachaware of the position of axillary n.
The intent of this protocol is to provide the clinician with a guideline of the postoperative rehabilitation course of a patient that has undergone an arthroscopic assistedminiopen rotator cuff repair. An uptodate metaanalysis of randomized controlled trials. Rehabilitation recovery from a shoulder surgery takes several months. The current study compared early postoperative outcomes between arthroscopic and miniopen repair for rotator cuff tears of smaller than 3 cm to test the hypothesis that, of the 2 techniques. It is no means intended to be a substitute for ones. The miniopen method of repairing a rotator cuff involves an arthroscopic portion of the surgery, and a short incision to get direct access to the torn rotator cuff tendon. Open surgery is required to repair the rotator cuff tear that is medium to large in size. Although the open surgical technique has long been considered the gold standard of rotator cuff repair, surgeons are becoming more adept at decreasing patient. Showering is allowed once dressings and catheter is removed. There was no difference in outcome at 1 and 2 years after surgery between the scope mini open and open procedures. If you have any questions regarding the progress of the patient, the physician should be contacted. This is an enhanced pdf from the journal of bone and joint surgery. Miniopen rotator cuff repair has been shown by several authors to provide predictable results similar to open repair. Rehabilitation guidelines for type i and type ii rotator.
If damage to the rotator cuff is extensive your surgeon may have to use an open incision rather than an arthroscope to complete the procedure. Pdf anterolateral approach for miniopen rotator cuff repair. The purpose of our study is to compare the functional results, isokinetic shoulder muscle strength and shoulder position sense of patients who have undergone allarthroscopic and mini open surgery to repair their rotator cuff tears. Each surgical repair technique open, mini open, and arthroscopic has similar results in terms of pain relief, improvement in strength and function, and patient satisfaction. Miniopen repair or arthroscopicassisted open rotator cuff repair is an arthroscopic subacromial decompression followed by an open repair through a deltoid splitting procedure, or the arthroscope may also be used to release adhesions and place tagging sutures with a. Arthroscopy is used to evaluate the injury, trim away bone spurs, and remove loose cartilage. Understand the anatomy of the cuff tear mobilise cuff properly so that the cuff is not fixed in too much of tension use of arthroscopic instruments very helpful can give better result if combined with. Smaller tears may be repaired arthroscopically, while larger ones shown may require an open incision of 2 to 3 inches. Allarthroscopic versus miniopen rotator cuff repair.
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