Comparative Efficacy of 5 Suture Configurations for Arthroscopic Rotator Cuff Tear Repair: a Network Meta-analysis

Overview

Journal J Orthop Surg Res

Publisher Biomed Central

Specialty Orthopedics

Date 2021 Dec 13

PMID 34895286

Citations 3

Authors

Wei Wang

Hui Kang

Hongchuan Li

Jian Li

Yibin Meng

Peng Li

Affiliations

Soon will be listed here.

Abstract

Background: Rotator cuff tear is one of the most common complaint with shoulder pain, disability, or dysfunction. So far, different arthroscopic techniques including single row (SR), double row (DR), modified Mason-Allen (MMA), suture bridge (SB) and transosseous (TO) have been identified to repair rotator cuff. However, no study has reported the comparative efficacy of these 5 suture configurations. The overall aim of this network meta-analysis was to analyze the clinical outcomes and healing rate with arthroscopy among SR, DR, MMA, SB and TO.

Methods: A systematic literature was searched from PubMed, EBSCO-MEDLINE, Web of Science, google scholar and www.dayi100.com , and checked for the inclusion and exclusion standards. The network meta-analysis was conducted using Review Manager 5.3 and SATA 15.0 software.

Results: Thirty-four studies were eligible for inclusion, including 15 randomized controlled trials, 17 retrospective and 2 prospective cohort studies, with total 3250 shoulders. Two individual reviewers evaluated the quality of the 34 studies, the score form 5 and 9 of 10 were attained according to the Newcastle-Ottawa Scale for the 17 retrospective and 2 prospective studies. There was no significant distinction for the Constant score among 5 groups in the 16 studies with 1381 shoulders. The treatment strategies were ranked as MMA, DR, SB, SR and TO. In ASES score, 14 studies included 1464 shoulders showed that no significant differences was showed among all 5 groups after surgery. Whereas the efficacy probability was TO, MMA, DR, SB and SR according to the cumulative ranking curve. The healing rate in 25 studies include 2023 shoulders was significant in both SR versus DR [risk ratio 0.45 with 95% credible interval (0.31, 0.65)], and SR versus SB [risk ratio 0.45 (95% credible interval 0.29, 0.69)], and no significant in the other comparison, the ranking probability was MMA, SB, DR, TO and SR.

Conclusion: Based on the clinical results, this network meta-analysis revealed that these 5 suture configurations shows no significant difference. Meanwhile, suture bridge may be the optimum treatment strategy which may improve the healing rate postoperatively, whereas the DR is a suboptimal option for arthroscopic rotator cuff repairs.

Citing Articles

Comparison between four different suture configurations for rotator cuff repair: a biomechanical animal study.

Haroun Y, Sobhy M, Khater H, Khater A SICOT J. 2024; 10:39.

PMID: 39374408 PMC: 11458134. DOI: 10.1051/sicotj/2024038.

Clinical Outcome of an All Arthroscopic 'Whole Layer' Rotator Cuff Repair Technique with Simultaneous Biceps Tenodesis.

Shih C, Lin P, Huang H, Hsieh C Orthop Surg. 2024; 16(11):2751-2760.

PMID: 39183513 PMC: 11541120. DOI: 10.1111/os.14198.

[Effectiveness analysis of arthroscopic single/double-row suture techniques in repairing of moderate rotator cuff tears].

Ning Z, Shi Z, Yang G, Dong K, Fan G, Jin X Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2023; 37(3):264-271.

PMID: 36940982 PMC: 10027526. DOI: 10.7507/1002-1892.202212026.

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