Rotator cuff repair is one of the most common surgical procedures done in t
he shoulder. Traditionally, repair has required an open incision with relea
se of a portion of the deltoid from the acromion. In the past decade, an ar
throscopically-assisted, mini-open approach has gained popularity. This has
been facilitated by advances in the use of arthroscopy. This trend toward
a more minimally invasive approach has continued as arthroscopic techniques
continue to improve and advance. An all-arthroscopic approach recently has
been used for rotator cuff repairs. The arthroscopic approach offers sever
al advantages including smaller incisions, easy access to the glenohumeral
joint for treatment of intraarticular diseases, less soft tissue dissection
, and less potential harm to the deltoid. The purpose of the current study
is to discuss recent advances in arthroscopic and mini-open rotator cuff re
pair techniques and to highlight the technical aspects of the mini-open pro
cedures that are important in making the transition to an all-arthroscopic
rotator cuff repair.