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

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.

<p>Promoting tendon to bone integration using graphene oxide-doped electrospun poly(lactic-co-glycolic acid) nanofibrous membrane</p>

“…The percentage of patients with failure after tendon to bone repair is relatively high. [34][35][36] The insertion of tendon/ ligament and bone is a strong mechanical structure established via a collagen fiber architecture and mineral composition in the native enthesis. 5,37-39 Therefore, it is likely that a fibrous membrane system that generates a fiber architecture and mineral composition will increase the feasibility of tendon to bone healing and may be the key to improve clinical prognosis.…”

Treating Rotator Cuff Tears Through a Coracoacromial Mini-Open Approach

“…If a standard primary arthroscopic exploration is performed, a subsequent decision to perform a secondary open treatment can be combined with the described approach. 1,16,17 As stated earlier, many techniques for the treatment of rotator cuff tears of the shoulder already have been described. Starting with Codman, followed by Bateman, De Palma, Neer, and other authors, 6 many variations of open surgery for rotator cuff tears have been described with increasing frequency.…”

Rotator Cuff Tears : Short- and long-term aspects on treatment outcome

“…Proponents of arthroscopic cuff repair often highlight better visualisation, less deltoid damage, quicker postoperative recovery, better cosmesis and less risk of infection as possible advantages. A meta-analysis in 2016 of 18 studies on cuff repair, amongst them 4 randomised trials, concluded that there was no overall difference in outcome between mini-open and all-arthroscopic techniques 128 . The large UKUFF-study, published in 2017, with 273 randomised participants from 19 hospitals, did not show a clinically relevant difference between the two techniques in a 2-year follow-up 35 .…”