Comparative functional outcomes of arthroscopic versus mini-open rotator cuff repair: A systematic review and meta-analysis

Background Rotator cuff tears are a common cause of shoulder pain and dysfunction in adults. Mini-open and all-arthroscopic rotator cuff repair are widely used, but their comparative effectiveness remains debated. This meta-analysis compared functional, pain, and range-of-motion outcomes between techniques. Methods PubMed, Web of Science, and Scopus were searched from inception to October 2025 for comparative studies in adults undergoing all-arthroscopic versus mini-open rotator cuff repair. Outcomes included ASES, Constant-Murley, DASH, range of motion, and VAS pain. Random-effects meta-analysis was performed using RevMan v5.4. Results Seventeen studies comprising 1185 patients met inclusion criteria. There were no statistically significant differences between techniques in ASES (MD: −1.40; p = 0.64), Constant-Murley (MD: −0.23; p = 0.91), DASH (MD: 2.00; p = 0.48), range of motion (MD: 2.58°–2.95°, all p > 0.20), or VAS pain (MD: −0.57; p = 0.06). Arthroscopic repair showed a nonsignificant trend toward lower pain, but functional and motion outcomes were clinically equivalent at both short- and long-term follow-up. Conclusions Arthroscopic and mini-open rotator cuff repairs showed comparable functional recovery, pain relief, and range-of-motion outcomes up to two years post-surgery. Further well-designed studies with standard protocols are needed to confirm these findings. Level of Evidence II, systematic review and meta-analysis