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Arthroscopic versus mini-open rotator cuff repair: A meta-analysis
Filippo Migliorini1, Nicola Maffulli2, Joerg Eschweiler1
1Department of Orthopaedic, Trauma, and Reconstructive Surgery, RWTH Aachen University Hospital, 52074 Aachen, Germany.
Summary
This meta-analysis found that all-arthroscopic rotator cuff repair (ASR) and mini-open rotator cuff repair (MOR) yield similar clinical outcomes. Factors like male gender, older age, and longer surgical duration may influence re-tear and adhesive capsulitis rates.
Area of Science:
- Orthopedic Surgery
- Sports Medicine
- Musculoskeletal Research
Background:
- Rotator cuff tears are common, impacting shoulder function and quality of life.
- Surgical repair aims to restore function and alleviate pain, with evolving techniques.
- Comparing all-arthroscopic rotator cuff repair (ASR) and mini-open rotator cuff repair (MOR) is crucial for optimizing patient outcomes.
Approach:
- A comprehensive meta-analysis was conducted by searching major online databases in October 2021.
- Included were randomized controlled trials directly comparing primary ASR versus MOR for rotator cuff ruptures.
- Exclusion criteria involved revision settings or combined surgical procedures.
Key Points:
- The analysis synthesized data from 21 articles, encompassing 1644 rotator cuff repair procedures (995 ASR, 649 MOR).
- No significant differences were observed between ASR and MOR groups regarding surgical duration, Constant score, UCLA score, ASES score, VAS pain, range of motion, or re-tear rates.
- Baseline characteristics such as age, gender, and follow-up duration were comparable between the two groups.
Conclusions:
- Both arthroscopic and mini-open rotator cuff repair techniques demonstrate comparable clinical outcomes.
- Patient factors including male gender and advanced age are associated with increased rotator cuff re-tear rates.
- Extended surgical duration correlates with a higher incidence of adhesive capsulitis post-repair.
