UKUFF is a pragmatic multicentre randomised trial comparing arthroscopic versus open repair of degenerative rotator cuff tears. It asks whether the increasingly popular arthroscopic approach actually delivers better outcomes than open repair. The primary endpoint was the Oxford Shoulder Score at two years, with imaging at one year to assess healing.
When a patient with a degenerative full-thickness cuff tear has failed conservative care and needs surgery, the approach you choose does not determine the result.
UKUFF is the largest RCT of rotator cuff repair ever done, and both techniques gave equivalent two-year outcomes with a confidence interval tight enough to exclude the clinically important difference. This is evidence of true equivalence, not an underpowered coin flip.
The more important lesson is biological. Roughly 40% of repairs re-tore, and healing status, not open versus arthroscopic technique, predicted outcome. Healed repairs did best, re-tears next, irreparable tears worst. Because re-tears occurred across all tear sizes and ages, the research target shifts from surgical approach to tendon-bone healing biology.
Practically: counsel patients that surgery reliably improves symptoms, that re-tear is common, and that the best outcomes follow a repair that actually heals.
UKUFF is a pragmatic multicentre randomised trial comparing arthroscopic versus open repair of degenerative rotator cuff tears. It asks whether the increasingly popular arthroscopic approach actually delivers better outcomes than open repair. The primary endpoint was the Oxford Shoulder Score at two years, with imaging at one year to assess healing.
When a patient with a degenerative full-thickness cuff tear has failed conservative care and needs surgery, the approach you choose does not determine the result.
UKUFF is the largest RCT of rotator cuff repair ever done, and both techniques gave equivalent two-year outcomes with a confidence interval tight enough to exclude the clinically important difference. This is evidence of true equivalence, not an underpowered coin flip.
The more important lesson is biological. Roughly 40% of repairs re-tore, and healing status, not open versus arthroscopic technique, predicted outcome. Healed repairs did best, re-tears next, irreparable tears worst. Because re-tears occurred across all tear sizes and ages, the research target shifts from surgical approach to tendon-bone healing biology.
Practically: counsel patients that surgery reliably improves symptoms, that re-tear is common, and that the best outcomes follow a repair that actually heals.