Functional outcomes of trans-tendon repair vs. tear completion and repair for partial thickness rotator cuff tears: A metaanalysis

Surgical treatment for partial rotator cuff tears may include debridement of the tear, subacromial decompression or repair of the tear. Repair of the tear can be either in-situ repair, or completion of the tear followed by repair. Though it is agreed that surgical repair is required for tears more than 50% of the thickness of rotator cuff, there is no consensus on ideal surgical treatment of these cases. This systematic review and meta-analysis was carried out to compare functional outcomes following these two different surgical treatments of PTRC tears. Search of electronic databases Google Scholar, PubMed, Ovid, and the Cochrane Register of Controlled Trials for published randomised controlled trials (RCTs) was undertaken. Search was done using a pre-designed search strategy. Critical appraisal of eligible studies was done for methodological quality using Cochrane Collaboration’s tool. Functional scores used for meta-analysis were visual analogue scale for pain, Constant Score and American Shoulder and Elbow Surgeons shoulder score. Four studies reporting total 282 repairs were eligible to be included in the meta-analysis. No statistically significant difference was found between the two groups in terms of Constant Score and American Shoulder and Elbow Surgeons shoulder score. Results were significantly better in the trans-tendon repair groups in terms of re-tear rates. There was no significant difference in functional outcome scores between the two groups. Tran-tendon repair technique may offer some benefits over tear completion and repair in terms of re-tear rates. Both techniques of surgical repair have shown equivalent functional outcomes at follow up. Current literature is insufficient to show superiority of one technique over the other.