Bone marrow-stimulating techniques in arthroscopic rotator cuff repair: a systematic review protocol

Area of Science:

• Orthopedic surgery
• Regenerative medicine
• Biomechanical engineering

Background:

• Bone marrow-stimulating (BMS) techniques are proposed to enhance biological healing in arthroscopic rotator cuff repair.
• The clinical efficacy and safety of BMS in improving tendon healing and patient outcomes remain unproven.
• A comprehensive review is needed to synthesize current evidence on BMS in rotator cuff surgery.

Purpose of the Study:

• To systematically review and meta-analyze randomized-controlled trials and retrospective cohort studies on BMS in arthroscopic rotator cuff repair.
• To determine the effects of BMS on tendon healing rates, pain, and shoulder function.
• To assess the associated harms and adverse events related to BMS interventions.

Main Methods:

• Systematic review and meta-analysis of randomized-controlled trials (RCTs) and retrospective cohort studies (RCS).
• Searches of major databases (Cochrane, Medline, Embase) and clinical trial registries up to August 23, 2018.
• Independent data extraction and risk of bias assessment using established tools (Cochrane Collaboration, ROBINS-I), followed by random-effects meta-analysis and GRADE assessment.

Main Results:

• Primary outcomes include tendon healing rate, overall pain, and shoulder function.
• Secondary outcomes encompass adverse events, range of motion, and return to previous activities.
• Pooled risk estimates will be calculated where appropriate, with overall data quality assessed using GRADE.

Conclusions:

• The review will provide evidence-based conclusions on the efficacy and safety of BMS in arthroscopic rotator cuff repair.
• Findings will inform clinical decision-making regarding the use of BMS techniques.
• Dissemination through peer-reviewed publications and conference presentations is planned.