{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:37:20Z","timestamp":1793385440208,"version":"4.5.0"},"reference-count":64,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T00:00:00Z","timestamp":1631664000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["MCT \u00c2? 82335"],"award-info":[{"award-number":["MCT \u00c2? 82335"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Patients with complete rotator cuff tears who fail a course of nonoperative therapy can benefit from surgical repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>This randomized trial compared mini-open (MO) versus all-arthroscopic (AA) rotator cuff repair.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Randomized controlled trial; Level of evidence, 1.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Patients with rotator cuff tears were randomized to undergo MO or AA repair at 9 centers by 23 surgeons. The primary outcome (Western Ontario Rotator Cuff Index [WORC]) and secondary outcomes (American Shoulder and Elbow Surgeons [ASES] score, Shoulder Pain and Disability Index [SPADI] pain subscale, 12-Item Short Form Health Survey [SF-12], reported medication use, adverse events), as well as measurements of range of motion and strength, were collected at 1 month before surgery; at 2 and 6 weeks postoperatively; and at 3, 6, 12, 18, and 24 months postoperatively. A blinded radiologist evaluated rotator cuff integrity on magnetic resonance imaging (MRI) at baseline and 1 year. Intention-to-treat analysis of covariance with the preoperative WORC score, age, and tear size as covariates assessed continuous outcomes. Sex differences were assessed. A meta-analysis synthesized the primary outcome between MO and AA repair with previous trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>From 954 patients screened, 411 were ineligible (276 because of recovery with physical therapy), 449 were screened at surgery (175 ineligible), and 274 completed follow-up (138 MO and 136 AA). The AA and MO groups were similar before surgery. WORC scores improved from 40 preoperatively to 89 (AA) and 93 (MO) at 2 years, for an adjusted mean difference of 3.4 (95% CI, \u20130.4 to 7.2). There were no statistically significant differences between the AA and MO groups at any time point. All secondary patient-reported outcomes were not significantly different between the MO and AA groups, except the 2-year SPADI pain score (8 vs 12, respectively; P = .02). A similar recovery in range of motion and strength occurred in both groups over time. MRI indicated minimal improvement in muscle relative to fat (AA: n = 3; MO: n = 2), with most worsening (AA: n = 25; MO: n = 24) or remaining unchanged (AA: n = 70; MO: n = 70). Opioid use was significantly reduced after surgery (from 21% to 5%). The meta-analysis indicated no significant standardized mean difference between groups in the primary outcome across all pooled studies (standardized mean difference, \u20130.06 [95% CI, \u20130.34 to 0.22]).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Both AA and MO rotator cuff repair provide large clinical benefits, with few adverse events. There is strong evidence of equivalent clinical improvements.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial Registration:<\/jats:title>\n                    <jats:p>NCT00128076.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465211038233","type":"journal-article","created":{"date-parts":[[2021,9,15]],"date-time":"2021-09-15T09:38:37Z","timestamp":1631698717000},"page":"3184-3195","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":38,"title":["Arthroscopic Versus Mini-open Rotator Cuff Repair: A Randomized Trial and Meta-analysis"],"prefix":"10.1177","volume":"49","author":[{"given":"Joy C.","family":"MacDermid","sequence":"first","affiliation":[{"name":"Departments of Surgery and Physical Therapy, University of Western Ontario, London, Ontario, Canada; Roth McFarlane Hand and Upper Limb Centre, St. Joseph\u2019s Health Care, London, Ontario, Canada"},{"name":"Investigation performed at the University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dianne","family":"Bryant","sequence":"additional","affiliation":[{"name":"Departments of Surgery and Physical Therapy, University of Western Ontario, London, Ontario, Canada"},{"name":"Investigation performed at the University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Holtby","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Holland Orthopaedic & Arthritic Centre, Toronto, Ontario, Canada"},{"name":"Investigation performed at the University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"Razmjou","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Holland Orthopaedic & Arthritis Centre, Sunnybrook Research Institute, Toronto, Ontario, Canada"},{"name":"Investigation performed at the University of Western Ontario, London, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Faber","sequence":"additional","affiliation":[{"name":"Department of Surgery, University of Western Ontario, London, Ontario, Canada; 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