Partial repair versus superior capsule reconstruction in managing massive rotator cuff tears. A meta-analysis of the current evidence

治疗巨大肩袖撕裂:部分修复与上关节囊重建的比较。现有证据的荟萃分析

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Abstract

BACKGROUND: Rotator cuff tear (RCT) is a common musculoskeletal condition. Managing RCTs can be challenging. Initial treatments typically involve conservative approaches such as physical therapy and corticosteroid injections. This meta-analysis compared the functional and clinical outcomes of two surgical techniques, Partial Repair (PR) and Superior Capsular Reconstruction (SCR), for managing rotator cuff tears. METHODS: The search included studies published in PubMed, Scopus, Web of Science, and Cochrane Library databases from 2013 to 2023. Studies comparing SCR with PR techniques in rotator cuff tear patients were included. Primary outcome was Constant shoulder score. RESULTS: Four cohort studies, totaling 235 patients, were included and analysed. There were no statistically significant differences between SCR and PR groups in constant shoulder score (P = 0.12), disabilities of the arm, shoulder, and hand (P = 0.42), acromiohumeral distance (P = 0.61), re-operation rate (P = 0.33), forward flexion (P = 0.73), and Visual Analog Score (VAS) score (P = 0.69). Heterogeneity was observed in some outcomes. DISCUSSION: Based on the available low level of evidence and observed heterogeneity, this meta-analysis did not identify significant disparities in functional and clinical outcomes between SCR and PR. Further high-quality clinical trials with larger sample sizes are warranted to confirm these findings.

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