In Situ Repair of Partial-thickness Rotator Cuff Tears. A Critical Analysis Review
Statement on the Treatment of Partial-Thickness Rotator Cuff Tears
Partial-thickness rotator cuff tears (PTRCTs) are a common cause of shoulder pain and dysfunction. The study at hand, “In Situ Repair for Partial-Thickness Articular-Sided Rotator Cuff Tears: A Systematic Review and Meta-Analysis of Clinical Outcomes“ by Liu et al. (2020), provides a comprehensive review and meta-analysis of the clinical outcomes of in situ repair for PTRCTs. This method involves the repair of the tear without converting it to a full-thickness tear, preserving the intact bursal-sided tendon.
The authors conducted a systematic review and meta-analysis of 11 studies, involving a total of 363 shoulders. The studies included were those that reported clinical outcomes of in situ repair for PTRCTs. The outcomes assessed included functional scores (Constant score, American Shoulder and Elbow Surgeons (ASES) score, and University of California, Los Angeles (UCLA) score), visual analog scale (VAS) for pain, and postoperative complications.
Results and Discussion
The meta-analysis revealed that in situ repair for PTRCTs resulted in significant improvements in functional scores and reduction in pain. The mean postoperative Constant score was 80.6, ASES score was 91.1, and UCLA score was 32.4. The mean postoperative VAS for pain was 1.1. The overall complication rate was 4.7%, with the most common complication being retear, which occurred in 3.6% of the cases.
These results suggest that in situ repair is an effective treatment for PTRCTs, leading to significant improvements in shoulder function and reduction in pain, with a low complication rate. However, the authors note that the evidence is limited by the lack of randomized controlled trials (RCTs) and the heterogeneity of the included studies.
In conclusion, the study by Liu et al. (2020) provides valuable evidence supporting the effectiveness of in situ repair for PTRCTs. However, further high-quality RCTs are needed to confirm these findings and to compare in situ repair with other treatment options for PTRCTs. The study by Ross et al. (2013) also highlights the importance of considering the potential complications and success rates of surgical procedures in the treatment of musculoskeletal conditions.