Transtendon technique <i>versus</i> repair after completion of the tear for articular-sided partial rotator cuff tear: a meta-analysis_West China Medical Journal

Authors：

 LIU Kai ¹ , WAN Fenglin ² , WANG Yongcai ¹ , HUANG Qiu ¹ , WANG Hongchuan ¹

1. Department of Orthopedics, People’s Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;
2. Department of Orthopedics, People’s Hosipital of Muchuan, Muchuan, Sichuan 614000, P. R. China;

Corresponding?author：

LIU Kai, Email: 285061643@qq.com

Keywords：

Articular-sided rotator cuff injuries; transtendon repair; repair after completion of tear; meta-analysis

DOI：

10.7507/1002-0179.202310122

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Objective To compare the clinical outcomes following arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear by meta-analysis. Methods Randomized controlled trials on arthroscopic repair for articular-sided partial rotator cuff tear using transtendon repair versus repair after completion of the tear were identified from Cochrane Library, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang database, and Chongqing VIP database, with a timespan from the inception of database to November 2024. Pain score, American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley score, postoperative adhesive capsulitis and postoperative retear were obtained as the outcomes to compare the clinical effect of the two methods. Meta-analyses were conducted using RevMan 5.3 software, with mean difference (MD) and relative risk (RR) as the effect scales. Results A total of 6 randomized controlled trial studies were included in the meta-analysis. The studies enrolled 370 patients, including 188 cases in the transtendon repair group and 182 cases in the repair after completion of the tear group. Pooled analyses demonstrated that the pain score [MD=0.26, 95% confidence interval (CI) (0.09, 0.42), P=0.003] and ASES score [MD=2.02, 95%CI (0.95, 3.10), P=0.0002] were higher in the transtendon repair group than those in the repair after completion of the tear group, the Constant-Murley score was lower in the transtendon repair group than that in the repair after completion of the tear group [MD=?3.32, 95%CI (?6.17, ?0.46), P=0.02], and there was no significant difference in the incidence of postoperative adhesive capsulitis [RR=1.12, 95%CI (0.36, 3.42), P=0.85] or the incidence of retear [RR=0.32, 95%CI (0.10, 1.03), P=0.06] between two groups. Conclusions Transtendon technique is less effective in reducing pain for articular-sided partial rotator cuff tear. There is no significant difference in the incidence of postoperative adhesive capsulitis or retear between the two gorups.

Citation： LIU Kai, WAN Fenglin, WANG Yongcai, HUANG Qiu, WANG Hongchuan. Transtendon technique versus repair after completion of the tear for articular-sided partial rotator cuff tear: a meta-analysis. West China Medical Journal, 2024, 39(11): 1753-1758. doi: 10.7507/1002-0179.202310122 Copy

1.	Zhang L, Fang Z, Zhang Y, et al. Comparison of the clinical efficacy and prognosis of the two techniques for treating partial articular-sided supraspinatus tendon tears under arthroscopy. BMC Musculoskelet Disord, 2024, 25(1): 519.
2.	Chen JJ, Ye Z, Liang JW, et al. Arthroscopic repair of partial articular supraspinatus tendon avulsion lesions by conversion to full-thickness tears through a small incision. Chin J Traumatol, 2020, 23(6): 336-340.
3.	Dey Hazra RO, Dey Hazra ME, Hanson JA, et al. Minimum 10-year outcomes after arthroscopic repair of partial-thickness supraspinatus rotator cuff tears. Am J Sports Med, 2023, 51(9): 2404-2410.
4.	Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy, 2012, 28(1): 25-33.
5.	Franceschi F, Papalia R, Del Buono A, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial. Int Orthop, 2013, 37(8): 1487-1493.
6.	Castagna A, Borroni M, Garofalo R, et al. Deep partial rotator cuff tear: transtendon repair or tear completion and repair? A randomized clinical trial. Knee Surg Sports Traumatol Arthrosc, 2015, 23(2): 460-463.
7.	Kim YS, Lee HJ, Bae SH, et al. Outcome comparison between in situ repair versus tear completion repair for partial thickness rotator cuff tears. Arthroscopy, 2015, 31(11): 2191-2198.
8.	李嘉, 趙紅蓮, 王智慧, 等. 關節鏡下兩種技術治療肩袖關節側部分撕裂的療效比較. 臨床骨科雜志, 2022, 25(4): 527-531.
9.	林志偉, 張敏敏, 林正龍. 關節鏡下轉全層修復和部分修復關節側部分肩袖損傷的療效對比. 中外醫療, 2024, 43(14): 43-46.
10.	Sella GDV, Silva LAD, Checchia CS, et al. Comparative clinical evaluation of two techniques of arthroscopic treatment of partial articular rotator cuff tears. Rev Bras Ortop (Sao Paulo), 2021, 56(6): 726-732.
11.	Thamrongskulsiri N, Limskul D, Itthipanichpong T, et al. Similar outcomes between transtendon repair and tear completion repair techniques for partial articular-sided supraspinatus tendon avulsion lesions: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2023, 31(10): 4575-4584.
12.	Peters KS, Lam PH, Murrell GA. Repair of partial-thickness rotator cuff tears: a biomechanical analysis of footprint contact pressure and strength in an ovine model. Arthroscopy, 2010, 26(7): 877-884.
13.	Jeong JJ, Park SE, Ji JH, et al. Trans-tendon suture bridge rotator cuff repair with tenotomized pathologic biceps tendon augmentation in high-grade PASTA lesions. Arch Orthop Trauma Surg, 2020, 140(1): 67-76.
14.	Zafra M, Uceda P, Mu?oz-Luna F, et al. Arthroscopic repair of partial-thickness articular surface rotator cuff tears: single-row transtendon technique versus double-row suture bridge (transosseous equivalent) fixation: results from a prospective randomized study. Arch Orthop Trauma Surg, 2020, 140(8): 1065-1071.
15.	Jordan RW, Bentick K, Saithna A. Transtendinous repair of partial articular sided supraspinatus tears is associated with higher rates of stiffness and significantly inferior early functional scores than tear completion and repair: a systematic review. Orthop Traumatol Surg Res, 2018, 104(6): 829-837.
16.	戴金良, 馬健, 杜庚衡, 等. 經肌腱修補法和轉化為全層后修補法治療 Ellman3 度岡上肌腱關節側部分撕裂的臨床研究. 中國運動醫學雜志, 2021, 40(1): 7-11.
17.	Yuan T, Yang S, Qian H, et al. All-inside technique versus in situ transtendon repair for Ellman Ⅲ partial articular supraspinatus tendon avulsion. J Shoulder Elbow Surg, 2023, 32(1): 24-32.
18.	Brockmeier SF, Dodson CC, Gamradt SC, et al. Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes. Arthroscopy, 2008, 24(8): 961-965.
19.	Gonzalez-Lomas G, Kippe MA, Brown GD, et al. In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg, 2008, 17(5): 722-728.
20.	Kanatl? U, Ayano?lu T, Atao?lu MB, et al. Midterm outcomes after arthroscopic repair of partial rotator cuff tears: a retrospective study of correlation between partial tear types and surgical technique. Acta Orthop Traumatol Turc, 2020, 54(2): 196-201.

1. Zhang L, Fang Z, Zhang Y, et al. Comparison of the clinical efficacy and prognosis of the two techniques for treating partial articular-sided supraspinatus tendon tears under arthroscopy. BMC Musculoskelet Disord, 2024, 25(1): 519.
2. Chen JJ, Ye Z, Liang JW, et al. Arthroscopic repair of partial articular supraspinatus tendon avulsion lesions by conversion to full-thickness tears through a small incision. Chin J Traumatol, 2020, 23(6): 336-340.
3. Dey Hazra RO, Dey Hazra ME, Hanson JA, et al. Minimum 10-year outcomes after arthroscopic repair of partial-thickness supraspinatus rotator cuff tears. Am J Sports Med, 2023, 51(9): 2404-2410.
4. Shin SJ. A comparison of 2 repair techniques for partial-thickness articular-sided rotator cuff tears. Arthroscopy, 2012, 28(1): 25-33.
5. Franceschi F, Papalia R, Del Buono A, et al. Articular-sided rotator cuff tears: which is the best repair? A three-year prospective randomised controlled trial. Int Orthop, 2013, 37(8): 1487-1493.
6. Castagna A, Borroni M, Garofalo R, et al. Deep partial rotator cuff tear: transtendon repair or tear completion and repair? A randomized clinical trial. Knee Surg Sports Traumatol Arthrosc, 2015, 23(2): 460-463.
7. Kim YS, Lee HJ, Bae SH, et al. Outcome comparison between in situ repair versus tear completion repair for partial thickness rotator cuff tears. Arthroscopy, 2015, 31(11): 2191-2198.
8. 李嘉, 趙紅蓮, 王智慧, 等. 關節鏡下兩種技術治療肩袖關節側部分撕裂的療效比較. 臨床骨科雜志, 2022, 25(4): 527-531.
9. 林志偉, 張敏敏, 林正龍. 關節鏡下轉全層修復和部分修復關節側部分肩袖損傷的療效對比. 中外醫療, 2024, 43(14): 43-46.
10. Sella GDV, Silva LAD, Checchia CS, et al. Comparative clinical evaluation of two techniques of arthroscopic treatment of partial articular rotator cuff tears. Rev Bras Ortop (Sao Paulo), 2021, 56(6): 726-732.
11. Thamrongskulsiri N, Limskul D, Itthipanichpong T, et al. Similar outcomes between transtendon repair and tear completion repair techniques for partial articular-sided supraspinatus tendon avulsion lesions: a systematic review and meta-analysis. Knee Surg Sports Traumatol Arthrosc, 2023, 31(10): 4575-4584.
12. Peters KS, Lam PH, Murrell GA. Repair of partial-thickness rotator cuff tears: a biomechanical analysis of footprint contact pressure and strength in an ovine model. Arthroscopy, 2010, 26(7): 877-884.
13. Jeong JJ, Park SE, Ji JH, et al. Trans-tendon suture bridge rotator cuff repair with tenotomized pathologic biceps tendon augmentation in high-grade PASTA lesions. Arch Orthop Trauma Surg, 2020, 140(1): 67-76.
14. Zafra M, Uceda P, Mu?oz-Luna F, et al. Arthroscopic repair of partial-thickness articular surface rotator cuff tears: single-row transtendon technique versus double-row suture bridge (transosseous equivalent) fixation: results from a prospective randomized study. Arch Orthop Trauma Surg, 2020, 140(8): 1065-1071.
15. Jordan RW, Bentick K, Saithna A. Transtendinous repair of partial articular sided supraspinatus tears is associated with higher rates of stiffness and significantly inferior early functional scores than tear completion and repair: a systematic review. Orthop Traumatol Surg Res, 2018, 104(6): 829-837.
16. 戴金良, 馬健, 杜庚衡, 等. 經肌腱修補法和轉化為全層后修補法治療 Ellman3 度岡上肌腱關節側部分撕裂的臨床研究. 中國運動醫學雜志, 2021, 40(1): 7-11.
17. Yuan T, Yang S, Qian H, et al. All-inside technique versus in situ transtendon repair for Ellman Ⅲ partial articular supraspinatus tendon avulsion. J Shoulder Elbow Surg, 2023, 32(1): 24-32.
18. Brockmeier SF, Dodson CC, Gamradt SC, et al. Arthroscopic intratendinous repair of the delaminated partial-thickness rotator cuff tear in overhead athletes. Arthroscopy, 2008, 24(8): 961-965.
19. Gonzalez-Lomas G, Kippe MA, Brown GD, et al. In situ transtendon repair outperforms tear completion and repair for partial articular-sided supraspinatus tendon tears. J Shoulder Elbow Surg, 2008, 17(5): 722-728.
20. Kanatl? U, Ayano?lu T, Atao?lu MB, et al. Midterm outcomes after arthroscopic repair of partial rotator cuff tears: a retrospective study of correlation between partial tear types and surgical technique. Acta Orthop Traumatol Turc, 2020, 54(2): 196-201.

West China Medical Journal

Transtendon technique versus repair after completion of the tear for articular-sided partial rotator cuff tear: a meta-analysis

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