Journal article
Systematic review: what surgical technique provides the best outcome for symptomatic partial articular-sided rotator cuff tears?
The Iowa orthopaedic journal, Vol.32, pp.164-172
2012
PMCID: PMC3565397
PMID: 23576937
Appears in Diamond Open Access
Abstract
There is no consensus in the literature regarding the optimal surgical treatment of symptomatic partial rotator cuff tears. We attempted to determine the optimal surgical treatment for partial articular-sided rotator cuff tears through a systematic review of appropriate studies.
Medline®, PubMed, Ovid, and the cochrane register of controlled trials were searched for all studies published between January 1991 to March 2010 that used the key words "shoulder", "partial rotator cuff tear", "PASTA", "articularsided rotator cuff tear", "incomplete rotator cuff tear", "arthroscopic" and "repair". Inclusion criteria were studies (Level I to IV) that reported clinical outcomes in patients who had arthroscopic evaluation and arthroscopic or mini-open treatment of a symptomatic partial articular-sided rotator cuff tear. One of three surgical treatments was used: debridement with or without acromioplasty; transtendon arthroscopic repair; or tear completion with repair. Exclusion criteria included studies with over 50% overhead throwers or athletes, studies that involved an open approach to the rotator cuff without arthroscopy, and data presented in technical notes or review papers. Data abstracted from the studies included patient demographics, tear characteristics, surgical procedure(s), and clinical outcomes.
Of 588 studies involving partial rotator cuff tears, 14 studies were identified which met our inclusion and exclusion criteria. All studies were Level IV retrospective case-series studies. Seven studies reported outcomes after rotator cuff debridement. Tear completion and repair was performed in three studies. Transtendon repair of a partial articular-sided rotator cuff tear was performed in three studies. Although different outcome measures were used, each study reported subjective and objective improvement postoperatively. One study compared outcomes in patients who underwent arthroscopic debridement versus another group where patients had tear completion and mini-open repair. Improved long-term results and decreased reoperation rates were reported in the tear completion and repair group.
On the basis of the available evidence, no single technique provides superior clinical outcomes. Level I and II comparison studies are needed to determine the optimal treatment of partial articular-sided rotator cuff tears.
Details
- Title: Subtitle
- Systematic review: what surgical technique provides the best outcome for symptomatic partial articular-sided rotator cuff tears?
- Creators
- Matthew Bollier - Dept of Orthopaedic Surgery, University of Iowa, USA. matthew-bollier@uiowa.eduKevin Shea
- Resource Type
- Journal article
- Publication Details
- The Iowa orthopaedic journal, Vol.32, pp.164-172
- Publisher
- Dept. of Orthopaedics, The University of Iowa; United States
- PMID
- 23576937
- PMCID
- PMC3565397
- ISSN
- 1541-5457
- eISSN
- 1555-1377
- Language
- English
- Date published
- 2012
- Academic Unit
- Orthopedics and Rehabilitation
- Record Identifier
- 9984040212002771
Metrics
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