Mini-open rotator cuff repair: an updated perspective.

The mini-open rotator cuff or arthroscopically assisted surgical procedure for repair of the rotator cuff has become a popular procedure with proven clinical results. The development of this procedure has followed a natural progression toward more minimally invasive means to accomplish rotator cuff repair. For many, it represents a middle ground between the traditional formal open repair and the newer complete arthroscopic rotator cuff repairs. As arthroscopic rotator cuff repair becomes more refined and accepted, the mini-open repair can also represent an excellent transitional technique to someday accomplish the more technically difficult complete arthroscopic repair. Whether used as the definitive rotator cuff repair procedure or as a transitional procedure toward arthroscopic repair, the mini-open repair can be thought of as two different types of procedures, an arthroscopically assisted open repair in which the actual repair is performed in a primarily open fashion, or as a mini-open assisted arthroscopic repair in which most of the repair is performed arthroscopically and an open exposure provided just for bone-tendon fixation. With either strategy, the mini-open repair represents an excellent technique for treating full-thickness rotator cuff tears and offers many of the advantages of either formal or complete arthroscopic repair while minimizing many of the disadvantages.