Meta-analysis of the surgical repair of rotator cuff tears: A comparison of arthroscopic and open techniques.

Authors: Metcalf et al.

References: Presented at AAOS 2003

Purpose: The purpose of this study is to compare open and arthroscopic techniques by performing a meta-analysis of the published reports. Methods: A Medline search was performed to identify all possible peer-reviewed series of repair of rotator cuff tears. Only series where there was a complete tear and the cuff was repaired back down to bone were included. Patient age, size of the tear, and the number of months follow-up were recorded to insure compared groups were similar. Outcome measures included strength, percent of good and excellent functional results, percent of patients satisfied with their surgery and pain scores. Results: There were 1845 patients treated with an open repair, compared to 373 arthroscopic cases. Average age, length of follow-up percent of patients with tears greater than three centimeters were similar. 83% of patients in open series and 87% of patients in arthroscopic series had good or excellent result. 89% of patients in open series and 90% of patients in arthroscopic series had satisfactory result and pain control. Average strength was 4.2 for open techniques and 4.4 for arthroscopic techniques. None of the results were significantly different. There was also no difference in patients treated with a mini-open technique versus all arthroscopic technique. Summary: Meta-analysis demonstrated no significant difference in any of these three techniques. Treatment of rotator cuff tears would seem to be dependent more on the individual expertise of the surgeon, than the technique chosen to accomplish the repair.


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