Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials

Hongfu Jin; Zhenhan Deng; Jianfeng Sun; Djandan Tadum Arthur Vithran; Wenfeng Xiao; Yusheng Li

doi:10.1093/burnst/tkad052

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Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials

更新时间：2024-04-19

- Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials
- Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials
- Burns & Trauma 2024年12卷第1期
- 作者机构：
  
  1. Department of Orthopedics
  2. Central South University
  3. National Clinical Research Center for Geriatric Disorders
  4. Department of Orthopaedic Surgery, The First Affiliated Hospital of Wenzhou Medical University
- 作者简介：
- 基金信息：
  
  This work was supported by the National Natural Science Foundation of China (82072506, 82272611, 92268115), Hunan Young Talents of Science and Technology (No. 2021RC3025), Provincial Clinical Medical Technology Innovation Project of Hunan (No. 2020SK53709), Wu Jieping Medical Foundation (320.6750.2020-03-14), National Clinical Research Center for Geriatric Disorders (Xiangya Hospital, No. 2021KF02), National Clinical Research Center for Orthopedics Sports Medicine and Rehabilitation (2021-NCRC-CXJJ-PY-40), Exploration and Innovation Project for Undergraduate Students of Hunan (CX20230303) and the Fundamental Research Funds for the Central Universities of Central South University (2023ZZTS0229).
- DOI：10.1093/burnst/tkad052
  中图分类号：
- 纸质出版日期：2024，
  
  网络出版日期：2024-2-9，
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Hongfu Jin, Zhenhan Deng, Jianfeng Sun, 等. Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials[J]. Burns & Trauma, 2024,12(1).

Hongfu Jin, Zhenhan Deng, Jianfeng Sun, Djandan Tadum Arthur Vithran, Wenfeng Xiao, Yusheng Li, Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials, Burns & Trauma, Volume 12, 2024, tkad052, https://doi.org/10.1093/burnst/tkad052
Hongfu Jin, Zhenhan Deng, Jianfeng Sun, 等. Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials[J]. Burns & Trauma, 2024,12(1). DOI： 10.1093/burnst/tkad052.

Hongfu Jin, Zhenhan Deng, Jianfeng Sun, Djandan Tadum Arthur Vithran, Wenfeng Xiao, Yusheng Li, Surgical management for massive rotator cuff tears: a network meta-analysis of randomized controlled trials, Burns & Trauma, Volume 12, 2024, tkad052, https://doi.org/10.1093/burnst/tkad052 DOI：

摘要

Abstract

BackgroundMultiple surgical strategies have been developed for treating massive rotator cuff tears (mRCTs). However

there is still no consensus on the best surgical option for mRCTs. Through a network meta-analysis

we aimed to comprehensively and systematically analyse the evidence in randomized controlled trials to help clinicians make evidence-based clinical decisions for patients with mRCTs.MethodsOur study was a network meta-analysis of the surgical management of mRCTs (PROSPERO Registration ID: CRD42023397971). We searched PubMed

EMBASE

Cochrane and Web of Science for randomized controlled trials that examined the efficacy of surgical management for mRCTs up to 3 November 2022. A three-step method was employed for the study process. Study selection

data extraction and risk of bias evaluation were conducted by two independent reviewers. R software (version 4.2.1) and Stata (version 15.1) were used for the data analysis.ResultsFrom 10

633 publications

we included 15 randomized controlled trials (996 participants) for the quantitative analysis. In terms of both long-term and short-term surgical effects

there were no statistically significant differences among surgical interventions such as patch-augmented rotator cuff repair (RCR)

RCR with platelet-rich plasma

arthroscopic decompression

bridging reconstruction

arthroscopic RCR with platelet-leukocyte membrane

open RCR

mini-open RCR

arthroscopic debridement

superior capsular reconstruction

arthroscopic suture-spanning augmented repair

subacromial balloon spacer and latissimus dorsi tendon transfer. Based on algorithms

the probability ranking suggests that patch augmentation is the most highly ranked surgical intervention for achieving better short-term surgical outcomes. Furthermore

arthroscopic-associated mini-open RCR was ranked as the highest surgical intervention for achieving better long-term surgical effects.ConclusionsBased on the available data from the included studies

similar surgical efficacies were observed among the reported intervention measures for mRCTs. The patch augmentation technique was found to potentially achieve better short-term surgical outcomes

which is consistent with previous reports. However

the best surgical interventions for achieving long-term surgical effects remain unknown. More high-quality research is needed to evaluate the efficacy and safety of these interventions and to guide clinical practice.

关键词

Keywords

Surgical managementMassive rotator cuff tearsShoulderNetwork meta-analysis

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