scholarly journals Comparative efficacy of 5 suture configurations for arthroscopic rotator cuff tear repair: a network meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Wei Wang ◽  
Hui Kang ◽  
Hongchuan Li ◽  
Jian Li ◽  
Yibin Meng ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Risk Ratio ◽  
Healing Rate ◽  
Meta Analysis ◽  
Credible Interval ◽  
Comparative Efficacy ◽  
Suture Bridge ◽  
Cuff Tear ◽  
Arthroscopic Rotator Cuff

Abstract Background Rotator cuff tear is one of the most common complaint with shoulder pain, disability, or dysfunction. So far, different arthroscopic techniques including single row (SR), double row (DR), modified Mason–Allen (MMA), suture bridge (SB) and transosseous (TO) have been identified to repair rotator cuff. However, no study has reported the comparative efficacy of these 5 suture configurations. The overall aim of this network meta-analysis was to analyze the clinical outcomes and healing rate with arthroscopy among SR, DR, MMA, SB and TO. Methods A systematic literature was searched from PubMed, EBSCO-MEDLINE, Web of Science, google scholar and www.dayi100.com, and checked for the inclusion and exclusion standards. The network meta-analysis was conducted using Review Manager 5.3 and SATA 15.0 software. Results Thirty-four studies were eligible for inclusion, including 15 randomized controlled trials, 17 retrospective and 2 prospective cohort studies, with total 3250 shoulders. Two individual reviewers evaluated the quality of the 34 studies, the score form 5 and 9 of 10 were attained according to the Newcastle–Ottawa Scale for the 17 retrospective and 2 prospective studies. There was no significant distinction for the Constant score among 5 groups in the 16 studies with 1381 shoulders. The treatment strategies were ranked as MMA, DR, SB, SR and TO. In ASES score, 14 studies included 1464 shoulders showed that no significant differences was showed among all 5 groups after surgery. Whereas the efficacy probability was TO, MMA, DR, SB and SR according to the cumulative ranking curve. The healing rate in 25 studies include 2023 shoulders was significant in both SR versus DR [risk ratio 0.45 with 95% credible interval (0.31, 0.65)], and SR versus SB [risk ratio 0.45 (95% credible interval 0.29, 0.69)], and no significant in the other comparison, the ranking probability was MMA, SB, DR, TO and SR. Conclusion Based on the clinical results, this network meta-analysis revealed that these 5 suture configurations shows no significant difference. Meanwhile, suture bridge may be the optimum treatment strategy which may improve the healing rate postoperatively, whereas the DR is a suboptimal option for arthroscopic rotator cuff repairs.

SYSTEMATIC REVIEW WITH NETWORK META-ANALYSIS OF RANDOMIZED CONTROLLED TRIALS OF ROTATOR CUFF TEAR TREATMENT

2018 ◽  
Vol 34 (1) ◽  
pp. 78-86 ◽  
Author(s):  
Seihee Kim ◽  
Jinseub Hwang ◽  
Min Jee Kim ◽  
Jae-Young Lim ◽  
Woo Hyung Lee ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Open Surgery ◽  
Randomized Clinical Trials ◽  
Structural Integrity ◽  
Platelet Rich Plasma ◽  
Meta Analysis ◽  
Functional Improvement ◽  
Cuff Tear

Objectives:Rotator cuff tear is the leading cause of the decline in quality of life for older adults, but comparative evidence on treatment effectiveness is lacking. This study systematically reviewed the effects of various rotator cuff tear treatments through a Bayesian meta-analysis of the related randomized clinical trials (RCTs).Methods:We searched nine electronic databases for RCTs evaluating rotator cuff tear treatments from their inception through June 2017. A systematic review was performed following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and the National Institute for Health and Care Excellence-Decision Support Unit guidelines (Supplementary Table 1). Outcomes included functional improvement, pain one year after surgical treatment, and tendon structural integrity. The Bayesian network meta-analysis was applied for functional improvement and pain, based on an assumption of consistency and similarity. Tendon integrity was reported descriptively.Results:Fifteen RCTs were selected. Patients undergoing physiotherapy after open surgery showed statistically significant functional improvements compared with those undergoing physiotherapy only (mean differences, 9.1 [credible interval, 0.9–17.4]). Open surgery with physiotherapy was associated with a decrease in pain 1 year after treatment compared with when physiotherapy was combined with arthroscopic rotator cuff surgery, mini open surgery, platelet-rich plasma therapy, or physiotherapy alone (absolute value of mean difference 1.2 to 1.4). The tendon integrity results were inconsistent.Conclusions:Some surgical treatments were associated with significant improvement in function and pain, but evidence regarding their comparative effectiveness is still lacking. A well-designed RCT discussing functional and structural treatment outcomes is needed in future.

Acromion morphology and prevalence of rotator cuff tear: A systematic review and meta-analysis

2018 ◽  
Vol 32 (1) ◽  
pp. 122-130 ◽  
Author(s):  
Kimberly M. Morelli ◽  
Bradley R. Martin ◽  
Fatima H. Charakla ◽  
Anel Durmisevic ◽  
Gordon L. Warren
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Meta Analysis ◽  
Cuff Tear

Return to Sport After Rotator Cuff Tear Repair

2015 ◽  
Vol 44 (7) ◽  
pp. 1877-1887 ◽  
Author(s):  
Shahnaz Klouche ◽  
Nicolas Lefevre ◽  
Serge Herman ◽  
Antoine Gerometta ◽  
Yoann Bohu
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Meta Analysis ◽  
Return To Sport ◽  
Rate Of Return ◽  
Rotator Cuff Tears ◽  
Recreational Athletes ◽  
Cuff Tear ◽  
Competitive Athletes ◽  
Rotator Cuff Tear Repair

Background: One of the most frequent demands from athletes after rotator cuff tear repair is to return to sport, if possible at the same level of play. Purpose: The main goal of this study was to determine the rate of return to sport after treatment of rotator cuff tears. Study Design: Meta-analysis and systematic review. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines were followed to perform this systematic review and meta-analysis of the results in the literature, as well as for the presentation of results. A search of the literature was performed on the electronic databases MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the MINORS (Methodological Index for Nonrandomized Studies) checklist. Inclusion criteria were studies in English evaluating return to sport after treatment of traumatic, degenerative, partial or full-thickness rotator cuff tears in patients practicing a sport regularly, whatever the level, all ages and sports included. The main judgment criterion was the number of patients who returned to a sports activity after treatment of a rotator cuff tear. The criterion was analyzed in 2 ways: return to sport (yes/no) and the level of play (identical or higher/lower level). Results: Twenty-five studies were reviewed, including 859 patients (683 athletes), all treated surgically after a mean follow-up of 3.4 years (range, 0.3-13.4 years). The level of sports was recorded in 23 studies or 635 (93%) athletes and included 286 competitive or professional athletes and 349 recreational athletes. The most commonly practiced sports were baseball (224 participants), tennis (104 participants), and golf (54 participants). The overall rate of return to sport was 84.7% (95% CI, 77.6%-89.8%), including 65.9% (95% CI, 54.9%-75.4%) at an equivalent level of play, after 4 to 17 months. Of the professional and competitive athletes, 49.9% (95% CI, 35.3-64.6%) returned to the same level of play. Conclusion: Most recreational athletes return to sports at the same level of play as before their injury, but only half of professional and competitive athletes return to an equivalent level of play.

scholarly journals Current Biomechanical Concepts of Suture Bridge Repair Technique for Rotator Cuff Tear

2015 ◽  
Vol 2 (3) ◽  
pp. 284-288
Author(s):  
Ming-Long Yeh ◽  
◽  
Chih-Kai Hong ◽  
Wei-Ren Su ◽  
I-Ming Jou ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Tear ◽  
Suture Bridge ◽  
Cuff Tear ◽  
Repair Technique
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