A rotator cuff tear (RCT) is a common injury in patients with persistent pain in the shoulder, this could be accompanied by loss of function and strength. Arthroscopic or mini-open rotator cuff repair are possible therapeutic options, which can increase the Quality of Life (QoL) drastically.
and study design: The objective of this meta-analysis is to evaluate the QoL after arthroscopic or mini-open rotator cuff repair.
A literature search was conducted in PubMed and EMBASE from January 2000 to August 2014. All studies measuring the clinical outcomes after full thickness rotator cuff repair at 12 months were included. We only included randomized controlled trials with the following outcome measures; (1) Constant score; (2) American Shoulder and Elbow Score (ASES); (3) Simple Shoulder Test (SST); University of California Los Angeles Score (UCLA) and (4) Visual Analogue Score (VAS).
We included 14 randomized controlled trials that met our inclusion criteria with a total of 1142 shoulders. Five studies comparing rotator cuff repair with or without augmentation with Platelet Rich Plasma (PRP), four studies comparing repair with or without acromioplasty , one study comparing physiotherapy with cuff repair, two studies comparing the single row to double row fixation technique and one study comparing the mini-open to arthroscopic procedure for rotator cuff repair.
The Constant score had a mean increase of 30,3 points (SMD= 2.7, p < 0.001, 95% CI= 2.12 – 3,30) at 12 months after rotator cuff repair; the mean ASES score increased by 38,4 points (SMD =2.2, p <0,001, 95% CI= 2.07-2.41); mean SST increased by 5,9 points (SMD= 3.0, p< 0.001, 95% CI 2.24-3.79); mean UCLA improved by 12,2 points (SMD= 2.53, p < 0.001, 95% CI 2.16-2.90) and finally mean VAS score decreased by 4,2 points (SMD= -2.30, p <0.001, 95% CI -2.77-1.82).
Based on this meta-analysis, significant major improvements of the QoL measures after arthroscopic or mini-open rotator cuff repair are seen 12 months after surgery. The first choice of treatment for RCT still remains controversial.