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Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis

BACKGROUND: Delamination of rotator cuff tears during arthroscopic shoulder surgery has an incidence of 38% to 92%. Double-layer (DL) repair and en masse (EM) repair are most commonly used in this situation. PURPOSE: To compare the clinical results of the DL versus EM repair techniques for delaminat...

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Autores principales: Quan, Xiaolin, Wu, Jiangping, Liu, Zhibo, Li, Xiangwei, Xiao, Yujia, Shu, Han, Zhou, Anpei, Wang, Ting, Nie, Mao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588421/
https://www.ncbi.nlm.nih.gov/pubmed/37868220
http://dx.doi.org/10.1177/23259671231206183
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author Quan, Xiaolin
Wu, Jiangping
Liu, Zhibo
Li, Xiangwei
Xiao, Yujia
Shu, Han
Zhou, Anpei
Wang, Ting
Nie, Mao
author_facet Quan, Xiaolin
Wu, Jiangping
Liu, Zhibo
Li, Xiangwei
Xiao, Yujia
Shu, Han
Zhou, Anpei
Wang, Ting
Nie, Mao
author_sort Quan, Xiaolin
collection PubMed
description BACKGROUND: Delamination of rotator cuff tears during arthroscopic shoulder surgery has an incidence of 38% to 92%. Double-layer (DL) repair and en masse (EM) repair are most commonly used in this situation. PURPOSE: To compare the clinical results of the DL versus EM repair techniques for delaminated rotator cuff tears using a meta-analysis. STUDY DESIGN: Systematic review; level of evidence, 3. METHODS: We identified relevant studies comparing the clinical results of DL and EM repair for delaminated rotator cuff injuries in the PubMed, Embase, and Cochrane databases after the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The primary outcomes were the Constant score and retear rate. Additionally, we compared other postoperative shoulder functional scores, shoulder range of motion, and visual analog scale (VAS) pain scores between the 2 suture methods using a meta-analysis. The mean difference (MD) was compared for continuous outcomes, and the odds ratios (ORs) were compared for categorical outcomes. RESULTS: Of the 197 studies initially identified, 6 studies were included in this analysis. There were significant differences in the Constant score (MD, 8.64 [95% CI, 4.47 to 12.8]; P < .05) and external rotation (MD, 5.10 [95% CI, 2.63 to 7.56]; P < .05) between the 2 techniques, with DL repair having superior outcomes. No significant differences were observed between the 2 techniques in forward flexion (MD, 0.62 [95% CI, –1.18 to 2.43]; P = .50), VAS pain (MD, –0.03 [95% CI, –0.34 to 0.27]; P = .84), or retear rate (OR, 0.73 [95% CI, 0.37 to 1.41]; P = .35). CONCLUSION: Results of this review and meta-analysis suggest that DL repair was more beneficial than EM repair in terms of the Constant score and shoulder external rotation in patients with delaminated rotator cuff injuries.
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spelling pubmed-105884212023-10-21 Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis Quan, Xiaolin Wu, Jiangping Liu, Zhibo Li, Xiangwei Xiao, Yujia Shu, Han Zhou, Anpei Wang, Ting Nie, Mao Orthop J Sports Med Review BACKGROUND: Delamination of rotator cuff tears during arthroscopic shoulder surgery has an incidence of 38% to 92%. Double-layer (DL) repair and en masse (EM) repair are most commonly used in this situation. PURPOSE: To compare the clinical results of the DL versus EM repair techniques for delaminated rotator cuff tears using a meta-analysis. STUDY DESIGN: Systematic review; level of evidence, 3. METHODS: We identified relevant studies comparing the clinical results of DL and EM repair for delaminated rotator cuff injuries in the PubMed, Embase, and Cochrane databases after the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The primary outcomes were the Constant score and retear rate. Additionally, we compared other postoperative shoulder functional scores, shoulder range of motion, and visual analog scale (VAS) pain scores between the 2 suture methods using a meta-analysis. The mean difference (MD) was compared for continuous outcomes, and the odds ratios (ORs) were compared for categorical outcomes. RESULTS: Of the 197 studies initially identified, 6 studies were included in this analysis. There were significant differences in the Constant score (MD, 8.64 [95% CI, 4.47 to 12.8]; P < .05) and external rotation (MD, 5.10 [95% CI, 2.63 to 7.56]; P < .05) between the 2 techniques, with DL repair having superior outcomes. No significant differences were observed between the 2 techniques in forward flexion (MD, 0.62 [95% CI, –1.18 to 2.43]; P = .50), VAS pain (MD, –0.03 [95% CI, –0.34 to 0.27]; P = .84), or retear rate (OR, 0.73 [95% CI, 0.37 to 1.41]; P = .35). CONCLUSION: Results of this review and meta-analysis suggest that DL repair was more beneficial than EM repair in terms of the Constant score and shoulder external rotation in patients with delaminated rotator cuff injuries. SAGE Publications 2023-10-19 /pmc/articles/PMC10588421/ /pubmed/37868220 http://dx.doi.org/10.1177/23259671231206183 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc-nd/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits non-commercial use, reproduction and distribution of the work as published without adaptation or alteration, without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Review
Quan, Xiaolin
Wu, Jiangping
Liu, Zhibo
Li, Xiangwei
Xiao, Yujia
Shu, Han
Zhou, Anpei
Wang, Ting
Nie, Mao
Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title_full Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title_fullStr Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title_full_unstemmed Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title_short Outcomes After Double-Layer Repair Versus En Masse Repair for Delaminated Rotator Cuff Injury: A Systematic Review and Meta-analysis
title_sort outcomes after double-layer repair versus en masse repair for delaminated rotator cuff injury: a systematic review and meta-analysis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588421/
https://www.ncbi.nlm.nih.gov/pubmed/37868220
http://dx.doi.org/10.1177/23259671231206183
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