Systematic Review of All-Arthroscopic Versus Mini-Open Repair of Rotator Cuff Tears: A Meta-Analysis

Rongzhong Huang, Sanrong Wang, Yule Wang, Xiaoxia Qin, Yang Sun, Rongzhong Huang, Sanrong Wang, Yule Wang, Xiaoxia Qin, Yang Sun

Abstract

The objective of this study was to compare outcomes in patients with rotator cuff tears undergoing all-arthroscopic versus mini-open rotator cuff repair. A systematic review and meta-analysis of outcomes of all-arthroscopic repair versus mini-open repair in patients with rotator cuff repair was conducted. Studies meeting the inclusion criteria were screened and included from systematic literature search for electronic databases including Medline, Embase, Cochrane CENTRAL, and CINAHL library was conducted from 1969 and 2015. A total of 18 comparative studies including 4 randomized clinical trials (RCTs) were included. Pooled results indicate that there was no difference in the functional outcomes, range of motion, visual analog scale (VAS) score, and short-form 36 (SF-36) subscales. However, Constant-Murley functional score was found to be significantly better in patients with mini-open repair. However, the results of the review should be interpreted with caution due to small size and small number of studies contributing to analysis in some of the outcomes. All-arthroscopic and mini-open repair surgical techniques for the management of rotator cuff repair are associated with similar outcomes and can be used interchangeably based on the patient and rotator tear characteristics.

Figures

Figure 1. Trial flow of included studies.
Figure 1. Trial flow of included studies.
Figure 2. Forest plot showing the SMD…
Figure 2. Forest plot showing the SMD (standardized mean difference) and 95% CI for UCLA (University of California Los Angeles) after surgery.
Figure 3. Forest plot showing the SMD…
Figure 3. Forest plot showing the SMD (standardized mean difference) and 95% CI for ASES (American Shoulder and Elbow Surgeons) after surgery.
Figure 4. Forest plot showing the SMD…
Figure 4. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for constant score after surgery.
Figure 5. Forest plot showing the SMD…
Figure 5. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for DASH (Disabilities of the Arm, Shoulder and Hand) score after surgery.
Figure 6. Forest plot showing the SMD…
Figure 6. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for SST (Simple Shoulder Test) after surgery.
Figure 7. Forest plot showing the SMD…
Figure 7. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for forward flextion after surgery.
Figure 8. Forest plot showing the SMD…
Figure 8. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for forward flextion after surgery (sensitivity analysis).
Figure 9. Forest plot showing the SMD…
Figure 9. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for external rotation after surgery.
Figure 10. Forest plot showing the SMD…
Figure 10. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for external rotation after surgery (sensitivity analysis).
Figure 11. Forest plot showing the SMD…
Figure 11. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for abduction after surgery.
Figure 12. Forest plot showing the SMD…
Figure 12. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for internal rotation after surgery.
Figure 13. Forest plot showing the SMD…
Figure 13. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for VAS (Visual Analog Scale) (pain) after surgery.
Figure 14. Forest plot showing the SMD…
Figure 14. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for VAS (Visual Analog Scale) (function) after surgery.
Figure 15. Forest plot showing the SMD…
Figure 15. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for VAS (Visual Analog Scale) (function) after surgery (sensitivity analysis).
Figure 16. Forest plot showing the SMD…
Figure 16. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for SF-36 (Short-Form 36) (bodily pain) after surgery.
Figure 17. Forest plot showing the SMD…
Figure 17. Forest plot showing the SMD (standardized mean difference) and 95% CI (Confidence Interval) for SF-36 (Short-Form 36) (role physical) after surgery.

References

    1. Beaudreuil J., Dhénain M., Coudane H. & Mlika-Cabanne N. Clinical practice guidelines for the surgical management of rotator cuff tears in adults. Orthopaedics & Traumatology: Surgery & Research 96, 175–179 (2010).
    1. Huisstede B. M., Koes B. W., Gebremariam L., Keijsers E. & Verhaar J. A. Current evidence for effectiveness of interventions to treat rotator cuff tears. Manual therapy 16, 217–230 (2011).
    1. Pandey V. & Willems W. J. Rotator cuff tear: A detailed update. Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology 2, 1–14 (2015).
    1. Kang L., Henn R. F., Tashjian R. Z. & Green A. Early outcome of arthroscopic rotator cuff repair: a matched comparison with mini-open rotator cuff repair. Arthroscopy: The Journal of Arthroscopic & Related Surgery 23, 573–582. e572 (2007).
    1. Kasten P. et al.. Prospective randomised comparison of arthroscopic versus mini-open rotator cuff repair of the supraspinatus tendon. International orthopaedics 35, 1663–1670 (2011).
    1. Kim S.-H. et al.. Arthroscopic versus mini-open salvage repair of the rotator cuff tear: outcome analysis at 2 to 6 years’ follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery 19, 746–754 (2003).
    1. Köse K. Ç. et al.. Mini-open versus all-arthroscopic rotator cuff repair: comparison of the operative costs and the clinical outcomes. Advances in therapy 25, 249–259 (2008).
    1. Osti L., Papalia R., Paganelli M., Denaro E. & Maffulli N. Arthroscopic vs mini-open rotator cuff repair. A quality of life impairment study. International orthopaedics 34, 389–394 (2010).
    1. van der Zwaal P. et al.. Clinical outcome in all-arthroscopic versus mini-open rotator cuff repair in small to medium-sized tears: a randomized controlled trial in 100 patients with 1-year follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, 266–273 (2013).
    1. Verma N. N. et al.. All-arthroscopic versus mini-open rotator cuff repair: a retrospective review with minimum 2-year follow-up. Arthroscopy: The Journal of Arthroscopic & Related Surgery 22, 587–594 (2006).
    1. Youm T., Murray D. H., Kubiak E. N., Rokito A. S. & Zuckerman J. D. Arthroscopic versus mini-open rotator cuff repair: a comparison of clinical outcomes and patient satisfaction. Journal of shoulder and elbow surgery 14, 455–459 (2005).
    1. Zhang Z., Gu B., Zhu W., Zhu L. & Li Q. Arthroscopic versus mini-open rotator cuff repair: a prospective, randomized study with 24-month follow-up. European Journal of Orthopaedic Surgery & Traumatology 24, 845–850 (2014).
    1. Jung G.-H., Lee Y.-K. & Shin H.-K. Early postoperative outcomes between arthroscopic and mini-open repair for rotator cuff tears. Orthopedics (Online) 35, e1347 (2012).
    1. Ji X., Bi C., Wang F. & Wang Q. Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials. Arthroscopy: The Journal of Arthroscopic & Related Surgery 31, 118–124 (2015).
    1. Wang Y.-J., Song Y.-C., Fang R. & Hong H.-G. Comparison of therapeutic effect of arthroscope versus mini-open in treating rotator cuff impairment: A meta-analysis. Chinese Journal of Evidence-Based Medicine 10:10, 1222–1227 (2010).
    1. Morse K. et al.. Arthroscopic Versus Mini-open Rotator Cuff Repair A Comprehensive Review and Meta-analysis. The American journal of sports medicine 36, 1824–1828 (2008).
    1. Shan L., Fu D., Chen K., Cai Z. & Li G. All-arthroscopic versus mini-open repair of small to large sized rotator cuff tears: a meta-analysis of clinical outcomes. PloS one 9, e94421 (2014).
    1. Roy J.-S., MacDermid J. C. & Woodhouse L. J. A systematic review of the psychometric properties of the Constant-Murley score. Journal of Shoulder and Elbow Surgery 19, 157–164 (2010).
    1. Severud E. L., Ruotolo C., Abbott D. D. & Nottage W. M. All-arthroscopic versus mini-open rotator cuff repair: a long-term retrospective outcome comparison. Arthroscopy: The Journal of Arthroscopic & Related Surgery 19, 234–238 (2003).
    1. Nove-Josserand L. et al.. Occupational outcome after surgery in patients with a rotator cuff tear due to a work-related injury or occupational disease. A series of 262 cases. Orthopaedics & Traumatology: Surgery & Research 97, 361–366 (2011).
    1. Warner J. J., Tétreault P., Lehtinen J. & Zurakowski D. Arthroscopic versus mini-open rotator cuff repair: a cohort comparison study. Arthroscopy: The Journal of Arthroscopic & Related Surgery 21, 328–332 (2005).
    1. Chung S. W., Huong C. B., Kim S. H. & Oh J. H. Shoulder stiffness after rotator cuff repair: risk factors and influence on outcome. Arthroscopy: The Journal of Arthroscopic & Related Surgery 29, 290–300 (2013).
    1. Pearsall A. W., Ibrahim K. A. & Madanagopal S. G. The results of arthroscopic versus mini-open repair for rotator cuff tears at mid-term follow-up. Journal of orthopaedic surgery and research 2, 24 (2007).
    1. Zhang Q. et al.. Single-row or double-row fixation technique for full-thickness rotator cuff tears: a meta-analysis. PloS one 8, e68515 (2013).
    1. Xu C., Zhao J. & Li D. Meta-analysis comparing single-row and double-row repair techniques in the arthroscopic treatment of rotator cuff tears. Journal of Shoulder and Elbow Surgery 23, 182–188 (2014).
    1. Millett P. J., Warth R. J., Dornan G. J., Lee J. T. & Spiegl U. J. Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials. Journal of Shoulder and Elbow Surgery 23, 586–597 (2014).

Source: PubMed

스폰서 및 공동 작업자

건강 상태

약물 개입

3
구독하다