Dataset Information

Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis.

ABSTRACT:

Background

Scientific evidence is not clear regarding the routine use of acromioplasty in the treatment of rotator cuff repair. The aim of this study was to compare clinical outcomes between patients undergoing arthroscopic rotator cuff repair with and without concomitant acromioplasty.

Methods

Medline, Cochrane Library, and EMBASE databases were searched to identify eligible studies focused on arthroscopic rotator cuff repair with and without acromioplasty from January 2000 to February 2018. Postoperative functional outcomes, visual analog scale (VAS) for pain and reoperation rate were extracted for systemic analysis.

Results

Six randomized controlled trials (RCTs) and one cohort study (CS), including 651 patients, fulfilled our selection criteria. The results showed a significant difference in American Shoulder and Elbow Surgeons (ASES) score, but not in the Constant score, University of California-Los Angeles (UCLA) score, or Simple Shoulder Test (SST) score, in the treatment of rotator cuff tear with or without concomitant acromioplasty at the final follow-up. In the subgroup analysis, the results showed no significant differences between the two treatments in reoperation rate at the final follow-up or VAS score at 6 months postoperatively and final follow-up, but there was a significant difference in VAS score at 12 months postoperatively in favor of acromioplasty treatment. The evidence quality for each outcome evaluated by the GRADE system was low.

Conclusions

In summary, our present study demonstrated that acromioplasty treatment is significantly superior to nonacromioplasty in shoulder pain relief at 12 months postoperatively and in ASES score improvement at the final follow-up in conjunction with rotator cuff repair. However, these significant differences were not clinically relevant. Thus, there were no differences in shoulder function or pain scores for patients undergoing rotator cuff repair with and without acromioplasty. Further high-quality studies with larger sample sizes and long-term follow-ups are needed to clarify this issue.

SUBMITTER: Cheng C

PROVIDER: S-EPMC6237382 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis.

Cheng Cong C Chen Bin B Xu Hongwei H Zhang Zhongwei Z Xu Weibin W

PloS one 20181115 11

<h4>Background</h4>Scientific evidence is not clear regarding the routine use of acromioplasty in the treatment of rotator cuff repair. The aim of this study was to compare clinical outcomes between patients undergoing arthroscopic rotator cuff repair with and without concomitant acromioplasty.<h4>Methods</h4>Medline, Cochrane Library, and EMBASE databases were searched to identify eligible studies focused on arthroscopic rotator cuff repair with and without acromioplasty from January 2000 to Fe ...[more]

PMID: 30439995

Similar Datasets

Project description:BackgroundThe tears of rotator cuff is caused by the tears or aseptic inflammation of tendon tissue such as subscapular muscle, supraspinatus muscle, infraspinatus muscle, teres minor muscle, and so on, which make up the rotator cuff. Managements of rotator cuff disease often include acupuncture and manual therapy, usually delivered together. The aim of this review is to assess the effectiveness and safety of such interventions in patients with pain and dysfunction caused by rotator cuff tears.MethodsWe will search the EMBASE, the Cochrane Library, Ovid MEDLINE, PubMed, Web of Science, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, Wanfang Database, the Chongqing VIP, the US National Institute of Health, the NIH clinical registry Clinical Trials, the International Clinical Trials Registry Platform, the Australian New Zealand Clinical Trials Registry and the Chinese clinical registry, from their inception to April 1, 2020. Randomized controlled trials that include patients with rotator cuff tears receiving acupuncture and manual therapy versus a control group will be included. The selection of studies, data extraction and risk of bias assessment will be conducted by 2 independent researchers. A third review author will resolve disagreements. The dichotomous data will be presented as risk ratios with 95% CIs and the continuous data will be presented as weighted mean differences or standardized mean differences with 95% CIs. Evidence quality will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation system.DiscussionThis systematic review will provide updated evidence of various types of acupuncture and manual therapy specifically focuses on its effectiveness and safety for patients' pain and dysfunction caused by rotator cuff tears.Ethics and disseminationEthical approval is not necessary as this review will not require data from individual patients. The results of this will be published through peer-reviewed journal articles or conference presentations.RegistrationOpen Science Framework Preregistration. Registration number 10.17605/OSF.IO/M3NKV.

Project description:BackgroundThere is no consensus on the treatment of irreparable massive rotator cuff tears. The goal of this systematic review and meta-analysis was to (1) compare patient-reported outcome scores, (2) define failure and reoperation rates, and (3) quantify the magnitude of patient response across treatment strategies.MethodsThe MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and Scopus databases were searched for studies including physical therapy and operative treatment of massive rotator cuff tears. The criteria of the Methodological Index for Non-randomized Studies were used to assess study quality. Primary outcome measures were patient-reported outcome scores as well as failure, complication, and reoperation rates. To quantify patient response to treatment, we compared changes in the Constant-Murley score and American Shoulder and Elbow Surgeons (ASES) score with previously reported minimal clinically important difference (MCID) thresholds.ResultsNo level I or II studies that met the inclusion and exclusion criteria were found. Physical therapy was associated with a 30% failure rate among the included patients, and another 30% went on to undergo surgery. Partial repair was associated with a 45% retear rate and 10% reoperation rate. Only graft interposition was associated with a weighted average change that exceeded the MCID for both the Constant-Murley score and ASES score. Latissimus tendon transfer techniques using humeral bone tunnel fixation were associated with a 77% failure rate. Superior capsular reconstruction with fascia lata autograft was associated with a weighted average change that exceeded the MCID for the ASES score. Reverse arthroplasty was associated with a 10% prosthesis failure rate and 8% reoperation rate.ConclusionThere is a lack of high-quality comparative studies to guide treatment recommendations. Compared with surgery, physical therapy is associated with less improvement in perceived functional outcomes and a higher clinical failure rate.

Dataset Information

Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis.

Background

Methods

Results

Conclusions

Publications

Efficacy of concomitant acromioplasty in the treatment of rotator cuff tears: A systematic review and meta-analysis.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets