A Comparative Study of Functional Outcomes of Rotator Cuff Repairs Using Arthroscopy Versus Mini-Open Techniques

Background: Rotator cuff tears are among the most prevalent shoulder pathologies, with an estimated prevalence of 20.7% in the general population. Surgical management has evolved from open techniques to mini-open and all-arthroscopic approaches. Despite favourable outcomes reported for both, comparative data on functional outcomes using standardised instruments such as the DASH score remain limited, particularly in Indian clinical settings. Objectives: To compare the functional outcomes of rotator cuff repairs performed using arthroscopy versus mini-open techniques as measured by the DASH score, VAS pain scores, and postoperative rehabilitation progress. Methods: This prospective, hospital-based comparative study was conducted at Vydehi Institute of Medical Sciences, Bangalore, from April 2023 to April 2024. Thirty patients with supraspinatus and/or infraspinatus tendon tears (Snyder grade ≥3) were randomly assigned to arthroscopic (n=15) or mini-open (n=15) repair groups using the sealed envelope method. All surgeries were performed by the same surgical unit, and all patients followed a standardised three-phase rehabilitation protocol. Results: Both techniques showed significant improvements over time. Preoperative and early postoperative DASH scores were similar (p>0.05). Arthroscopy showed significantly lower DASH scores at 3 months (17.60 ± 11.64 vs. 23.60 ± 10.90; p=0.02), 6 months (11.80 ± 12.03 vs. 15.33 ± 10.25; p=0.03), and 12 months (4.53 ± 5.90 vs. 7.60 ± 5.19; p=0.04). Mini-open surgery had lower VAS pain scores at 3 months (p=0.04) and 6 months (p=0.01), though pain equalized by 12 months (p=0.43). Rehabilitation outcomes were comparable, with all patients achieving “Excellent” ratings by 6 months. Conclusion: Both techniques effectively restore shoulder function. Arthroscopy offers superior long-term functional recovery, while mini-open provides better intermediate-term pain relief. The choice should be individualised based on patient factors, tear characteristics, and surgeon expertise.