Which is the best repair of articular-sided rotator cuff tears: a meta-analysis
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RESEARCH ARTICLE
Open Access
Which is the best repair of articular-sided rotator cuff tears: a meta-analysis Lin Sun1,2†, Qiang Zhang3†, Heng’an Ge1, Yeqing Sun1 and Biao Cheng1*
Abstract Background: Tear conversion followed by repair and trans-tendon techniques have been widely used for partialthickness rotator cuff tears. Both of them showed favorable results with regard to the management of articular-sided partial-thickness rotator cuff tears (PTRCTs) of more than 50 % thickness. However, controversy continues with the best management. This study aims to compare the clinical outcomes between the two techniques. Methods: The PubMed, Embase, and Cochrane library databases were searched for relevant studies published before October 1, 2014. Studies that clearly reported a comparison between the two procedures were selected. The American Shoulder and Elbow Surgeons scale (ASES) and the re-tear rate were evaluated. Statistical analysis was performed using the special meta-analysis software called “Comprehensive Meta Analysis”. Results: Final meta-analysis after the full-text review included four studies about tear conversion followed by repair and seven studies about trans-tendon technique. The trans-tendon technique showed no significant difference with the tear conversion followed by repair technique with regard to the ASES scale (P = 0.69). But the re-tear rate (P < 0.05) was markedly lower in the trans-tendon technique group than the tear conversion and repair technique group. Conclusion: In conclusion, the meta-analysis suggests that the trans-tendon technique is better than the tear conversion followed by repair technique with regard to the management of articular-sided PTRCTs of more than 50 % thickness in the re-tear rate aspect. Keywords: Partial-thickness rotator cuff tears, Articular-sided, Trans-tendon technique, Tear conversion and repair technique
Introduction Partial-thickness rotator cuff tears (PTRCTs) may occur on the articular side, within the tendon, or on the bursal side, with the articular-sided tears being 2–3 times more common than bursal-sided tears [1, 2]. Since partialthickness tears do not have natural integrity potential and may progress to full-thickness tears, operative intervention is typically indicated for patients with persistent pain and disability symptoms, instead of failed conservative management [1, 3]. Several techniques have been introduced for the repair of PTRCTs, including acromioplasty alone, debridement of the partial-thickness tear with or without acromioplasty, trans-tendinous repair, or * Correspondence: [email protected] † Equal contributors 1 Department of Orthopedics, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, 301 Yanchang Middle Road, Shanghai 200072, China Full list of author information is available at the end of the article
conversion of the lesion to a full-thickness tear followed by repair. Nowadays, the trend is to repair lesions involving more than 50 % of the tendon thickness with the conversion and repair technique or trans
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