Retrospective review of open and arthroscopic repair of anterosuperior rotator cuff tears with subscapularis involvement: a single surgeon's experience

Background: There have been conflicting results when comparing outcomes of open vs. arthroscopic anterosuperior rotator cuff repairs with subscapularis involvement. The purpose of this study was to evaluate midterm outcome differences and complications following open vs. arthroscopic repair of rotator cuff tears involving the subscapularis by a single surgeon. Methods: This was a retrospective review of 57 rotator cuff repairs involving the subscapularis performed by a single surgeon over a 10-year period. During this time, the surgeon transitioned from open to arthroscopic repair. Preoperative and postoperative range of motion, lift-off test, belly press test, and American Shoulder and Elbow Surgeons (ASES) Standardized Shoulder Assessment form scores were measured. Results: Eighteen patients had open procedures and 39 had arthroscopic repair. The mean preoperative ASES score for the open group was 39 and postoperatively was 79. The mean preoperative ASES score for the arthroscopic group was 44 and improved to 80 postoperatively. There was no significant difference in score or change in score between the 2 groups (P > .05). There was only 1 complication. It occurred in the open group and was a superficial wound dehiscence. Conclusions: This study demonstrated no outcome differences between open and arthroscopic rotator cuff repair involving the subscapularis, even with large subscapularis tears. Both techniques significantly improved shoulder function. Arthroscopic and open rotator cuff repairs including the subscapularis are relatively safe procedures, and either technique is an acceptable option.