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：

Transtendon repair; completion; articular-sided; partial; rotator cuff tear

DOI：

10.7507/1002-0179.202310122

Video：

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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.

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, 赵红莲, 王智慧, 等. 关节镜下两种技术治疗肩袖关节侧部分撕裂的疗效比较. 临床骨科杂志, 2022, 25(4): 527-531.
9.	林志伟, 张敏敏, 林正龙. 关节镜下转全层修复和部分修复关节侧部分肩袖损伤的疗效对比. 中外医疗, 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, Muñoz-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, 马健, 杜庚衡, 等. 经肌腱修补法和转化为全层后修补法治疗 Ellman3 度冈上肌腱关节侧部分撕裂的临床研究. 中国运动医学杂志, 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.	Kanatlı U, Ayanoğlu T, Ataoğlu 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, 赵红莲, 王智慧, 等. 关节镜下两种技术治疗肩袖关节侧部分撕裂的疗效比较. 临床骨科杂志, 2022, 25(4): 527-531.
9. 林志伟, 张敏敏, 林正龙. 关节镜下转全层修复和部分修复关节侧部分肩袖损伤的疗效对比. 中外医疗, 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, Muñoz-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, 马健, 杜庚衡, 等. 经肌腱修补法和转化为全层后修补法治疗 Ellman3 度冈上肌腱关节侧部分撕裂的临床研究. 中国运动医学杂志, 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. Kanatlı U, Ayanoğlu T, Ataoğlu 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.

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