What Is the Difference Between Open and Mini-Open Rotator Cuff Repair?

Rotator cuff injuries are one of the most common causes of shoulder pain and weakness, often requiring surgical intervention when conservative treatments fail. Two of the main surgical options for repairing a torn rotator cuff are open repair and mini-open repair. While both techniques aim to reattach the torn tendons to the bone and restore shoulder function, they differ in how the surgeon accesses the shoulder and the extent of the incision.

Open Rotator Cuff Repair

Traditional open rotator cuff repair involves making a larger incision, typically 2 to 4 inches, over the shoulder. During the procedure, the surgeon moves aside the deltoid muscle to gain full access to the rotator cuff tendons. This direct view allows the surgeon to clearly see the tear and surrounding structures, making it an ideal option for treating large or complex tears, chronic injuries, or cases where additional procedures—such as tendon transfers or bone spur removal—are needed.

Because open repair requires a more extensive incision and dissection of the muscle, recovery may involve more post-operative discomfort and a longer rehabilitation period compared to less invasive methods. However, it remains a reliable and effective technique, particularly for more severe rotator cuff damage.

Mini-Open Rotator Cuff Repair

Mini-open rotator cuff repair combines the benefits of both traditional open surgery and modern arthroscopic techniques. It starts with an arthroscopic evaluation of the shoulder using small incisions and a camera to assess the damage, remove bone spurs, and prepare the area for repair. Once the initial arthroscopic portion is complete, the surgeon makes a smaller incision—usually about 1 to 2 inches—to complete the tendon repair.

The mini-open approach avoids cutting through the deltoid muscle, which helps reduce trauma to the surrounding tissues. As a result, patients often experience less pain, smaller scars, and a shorter recovery period compared to traditional open surgery. Mini-open repair is typically recommended for medium-sized tears or cases where the tear is too complex for a fully arthroscopic repair but doesn’t require the extensive exposure of an open procedure.

Key Differences

• Incision Size: Open repair uses a larger incision (2-4 inches), while mini-open uses a smaller incision (1-2 inches).
• Muscle Dissection: Open repair involves moving the deltoid muscle, while mini-open spares the muscle, reducing tissue trauma.
• Use of Arthroscopy: Mini-open repair begins with arthroscopic techniques, whereas open repair is entirely done through direct visualization.
• Recovery: Mini-open repair generally leads to faster recovery, less post-operative pain, and smaller scars compared to open repair.

Choosing the Right Approach

The choice between open and mini-open rotator cuff repair depends on factors such as the size and complexity of the tear, patient health, and the surgeon’s assessment. Both techniques have high success rates, and a qualified orthopedic specialist can recommend the best option tailored to the individual’s condition.

In summary, while both open and mini-open repairs effectively treat rotator cuff tears, the mini-open approach offers a less invasive alternative with a potentially quicker recovery time, especially for moderate injuries. Open repair remains the preferred choice for more severe or complex cases.