Improved outcomes with arthroscopic repair of partial-thickness rotator cuff tears: a systematic review View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-01

AUTHORS

J. Christoph Katthagen, Gabriella Bucci, Gilbert Moatshe, Dimitri S. Tahal, Peter J. Millett

ABSTRACT

PURPOSE: 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?". METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. LEVEL OF EVIDENCE: IV. More... »

PAGES

113-124

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00167-017-4564-0

DOI

http://dx.doi.org/10.1007/s00167-017-4564-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1085441620

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28526996


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259 Department of Orthopaedic Surgery, Oslo University Hospital and University of Oslo, Oslo, Norway
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263 schema:name Consorci Sanitari del Maresme, Hospital de Mataró, Barcelona, Spain
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270 schema:name Center for Outcomes-based Orthopaedic Research, Steadman Philippon Research Institute, 181 West Meadow Drive Suite 1000, 81657, Vail, CO, USA
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