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- Title
Improved outcomes with arthroscopic repair of partial-thickness rotator cuff tears: a systematic review.
- Authors
Katthagen, J. Christoph; Bucci, Gabriella; Moatshe, Gilbert; Tahal, Dimitri S.; Millett, Peter J.
- Abstract
<bold>Purpose: </bold>The optimum treatment strategy for the surgical management of partial-thickness rotator cuff tears (PTRCT) is evolving. In this study, two research questions were sought to be answered: "Does the repair technique for PTRCTs involving >50% of the tendon thickness have an effect on structural and functional outcomes of arthroscopic repair?" and "Is there a difference in outcomes of arthroscopically treated articular- and bursal-sided PTRCTs?".<bold>Methods: </bold>A systematic review according to the PRISMA statement was conducted to identify all literature published reporting on outcomes of arthroscopic treatment of PTRCTs classified with the Ellman classification with minimum 2-year follow-up. Prospective randomized trials were eligible for quantitative synthesis. A total of 19 studies, published between 1999 and 2015, met the inclusion criteria of this systematic review. Two studies reporting outcomes of articular-sided PTRCTs with prospective randomized study design were included in quantitative synthesis calculations.<bold>Results: </bold>Arthroscopic repair of PTRCTs >50% thickness results in significant pain relief and good to excellent functional outcomes. When in situ repair was compared with repair of the tendon after completion to full-thickness RCT, there were no significant differences in functional or structural outcomes or complication rates. The best treatment method for low-grade PTRCTs remains unclear.<bold>Conclusions: </bold>The repair technique (in situ repair versus repair of the tendon after completion to full-thickness RCT) did not significantly affect the outcomes for arthroscopic repair of PTRCTs >50% thickness. The current literature contains evidence for inferior outcomes and higher failure rates after arthroscopic debridement of bursal-sided compared to articular-sided PTRCTs, and some evidence suggests that repair of lower-grade bursal-sided tears may be beneficial over debridement.<bold>Level Of Evidence: </bold>IV.
- Subjects
ROTATOR cuff injuries; DEBRIDEMENT; ARTHROSCOPY; TENDONS; HEALTH outcome assessment; THERAPEUTICS; ROTATOR cuff surgery; SYSTEMATIC reviews; TREATMENT effectiveness
- Publication
Knee Surgery, Sports Traumatology, Arthroscopy, 2018, Vol 26, Issue 1, p113
- ISSN
0942-2056
- Publication type
journal article
- DOI
10.1007/s00167-017-4564-0