Rotator Cuff Repair Should Be Done Arthroscopically: Body of Evidence—Opposes

The surgical management of rotator cuff tears has seen a rapid evolution from open surgical techniques to arthroscopic techniques as the perceived treatment of choice. But like most things in medicine—“always” is never appropriate. Many surgeons believe that all cuff tears can and should be treated arthroscopically regardless of tear size, tear configuration, and other patient specific considerations. There remains a very critical role for the maintenance of surgical skills in the treatment of rotator cuff tears with open surgical technique, as this specific clinical case will review. Recent publications suggest a much greater failure rate in 2 tendon tears when treated arthroscopically when compared with the open technique. Despite the near-daily marketing of newer suture, newer anchors, newer materials, newer knotless anchors, etc., tendon biology and physiology have not changed. Although certain smaller tears can be very appropriately repaired arthroscopically, many larger tears should be treated with open surgery.