Comparative Study

SHORT-TERM FUNCTIONAL OUTCOMES IN ROTATOR CUFF REPAIR: A PROMS-BASED COMPARISON OF SURGICAL TECHNIQUES

G. Pipino1 ORCID, E.C. Moretti2 , N.G. Biavardi3 ORCID, F. Anzano2 , G. Placella3 ORCID, M. Alessio-Mazzola4 ORCID, P. Caldora5 ORCID, R. Borghi1 , D.C. Vaccarisi1 ORCID, F. Migliorini6 ORCID, V. Salini3 ORCID

1 Villa Erbosa, Bologna, Orthopedics III
2 Vita-Salute San Raffaele University, Milan, School of Specialization in Orthopedics and Traumatology
3 Vita-Salute University, IRCCS San Raffaele Hospital, Milan, Italy
4 IRCCS San Raffaele Hospital, Milan, Italy
5 San Giuseppe Hospital, Korian Group, Arezzo, Joint Prosthetic Surgery
6 Link Campus University of Rome, Research Department of Robotics

Correspondence to:

Enzo Claudio Moretti, MD
Vita-Salute San Raffaele University,
School of Specialization in Orthopedics and Traumatology,
Via Olgettina, 58
20132 Milano (MI), Italy

Journal of Orthopedics 2025 September-December; 17(3): 116-126
DOI https://doi.org/10.69149/orthopedics/2025v17iss3_12


Received: 3 November 2025 Accepted: 12 December 2025

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Abstract

Rotator cuff tears can be managed through surgical repair using mini-open (MO) or all-arthroscopic (AA) techniques. This study compares their functional outcomes and patient satisfaction using Patient-Reported Outcome Measures (PROMs). A retrospective, single-center cohort study included 81 patients undergoing rotator cuff repair at Villa Erbosa Hospital, Bologna, between May 2023 and May 2024. Patients were classified using Snyder’s system (C1-C3) and divided into MO (n=49) and AA (n=32) groups. Functional outcomes were assessed preoperatively and postoperatively (1 and 3 months) using ASES, Constant-Murley, and WORC scores. Statistical analyses included linear mixed models, ANCOVA, and multivariate regression, adjusting for confounding factors. Both techniques resulted in significant postoperative improvements. However, the AA group demonstrated a faster recovery trajectory, with superior PROMs at 90 days (ASES: p=0.019; CM: p=0.011; WORC: p=0.008). The proportion of patients achieving the minimum clinically important difference (MCID) was significantly higher in the AA group (p<0.05). Multivariate analysis confirmed AA as an independent predictor of better short-term outcomes (β=8.7, p<0.001 for ASES90). The findings suggest that while both techniques improve functional outcomes, AA accelerates recovery and leads to higher patient-reported satisfaction. Potential biases include differences in surgeon expertise and variability in anchor types. Arthroscopic rotator cuff repair yields superior early postoperative outcomes compared with the mini-open approach. Further studies with short-term follow-up are needed to confirm sustained benefits.

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