Comparison of clinical outcomes between knotted and knotless double-row arthroscopic rotator cuff repairs : a meta-analysis

© 2020 The Authors.

Détails bibliographiques
Publié dans:JSES international. - 2020. - 5(2021), 2 vom: 09. März, Seite 254-260
Auteur principal: Paramasivam Meenakshi Sundaram, Pirateb (Auteur)
Autres auteurs: Lee, Wei Wen Bryan, Sayampanathan, Andrew Arjun, Tan, Hwee Chye Andrew
Format: Article en ligne
Langue:English
Publié: 2021
Accès à la collection:JSES international
Sujets:Journal Article Review Rotator cuff repair double row knot tying knotless transosseous-equivalent
Description
Résumé:© 2020 The Authors.
BACKGROUND: The ideal rotator cuff repair technique should allow for a quick and simple arthroscopic application which provides both adequate biomechanical stability and an appropriate biological state with the intention of promoting eventual healing of tendon to bone. While the biomechanical superiority of double-row repairs including higher repair strength, reduced gap formation, and wider footprint restoration have been proven, controversy remains regarding the clinical benefits of knotless compared with knot tying techniques. Our study aims to review the available evidence in the literature comparing the clinical outcomes between knotted and knotless transosseous double-row rotator cuff repair techniques
METHODS: A systematic literature search via PubMed, Embase, and Scopus was conducted by 2 independent reviewers. Studies reporting clinical outcomes of arthroscopic rotator cuff repair using the double-row knotted and knotless surgical techniques were identified. Data were analyzed with Review Manager 5.3, using Mantel-Haenszel statistics with both fixed and random effect models
RESULTS: A total of 1144 studies were identified from our initial search. Based on our inclusion and exclusion criteria, 8 studies were eventually selected for our review. The selected studies were published between 2012 and 2018. Of the 8 studies, 3 reported level 2 evidence and 5 reported level 3 evidence. There were a total of 589 subjects. Our meta-analysis revealed that there were no significant differences in functional outcomes postoperatively when comparing Constant score (mean difference = -1.85, 95% confidence interval: -4.42 to 0.73), University of California at Los Angeles score (mean differences = -0.14, 95% confidence interval: -0.90 to 0.62), and American Shoulder and Elbow Surgeons score (mean differences = -2.19, 95% confidence interval: -5.55 to 1.17) between patients who underwent knotted and knotless rotator cuff repairs
DISCUSSIONS AND CONCLUSION: Our review revealed no statistically significant difference in functional outcomes between knotted and knotless transosseous double-row techniques for arthroscopic rotator cuff repairs. To our knowledge, this is the first meta-analysis related to this topic. However, no level 1 studies were available for this review. Further studies related to this topic should focus on reporting level 1 evidence comparing the clinical outcomes of knotless and knotted techniques for double-row repairs
Description:Date Revised 21.04.2022
published: Electronic-eCollection
Citation Status PubMed-not-MEDLINE
ISSN:2666-6383
DOI:10.1016/j.jseint.2020.10.007