A Meta-analysis Of The Clinical Efficacy And Safety Of Arthroscopic Versus Mini-open On Rotator Cuff Repair

Objective:The surgical treatment of rotator cuff injury is mainly about arthroscopy and mini-open, The purpose of this article is based on recently published literature, to compare clinical outcomes and complications of arthroscopy and mini-open in the treatment of rotator cuff tears with Meta-analysis. To provide clinical gist for the surgical treatment.Method:The databases including Pubmed, the Cochrane Library, Ovid, EMBASE, Wanfang data,CBD, conference proceedings and reference lists of articles and the Web of Science were searched by the computer from February 1990 to June 2015 for collecting Randomized or comparative studies on all arthroscopic rotator cuff repairs and mini-open repairs. According to the Cochrane recommended quality evaluation system, Inclusion criteria and Exclusion criteria are strict accordance with the standards by two independent study of extraction and filtering, data quality evaluation, using Rev Man5.2 software for Meta-analysis.Results:six RCT studies and four controlled clinical trial studies met the inclusion criteria and involved 682 patients, including 344 receiving all arthroscopic surgery and 338 receiving mini-open surgery. The results of the meta-analysis showed that there were no significant differences in surgery time(WMD=17.64;95%CI(-3.87,39.16);P=0.11),(RR=1.08,95%CI 1.02-1.14, P=0.01), University of California at Los Angeles Score(WMD=0.69;95%CI(-0.72,2.11);P=0.34), American Shoulder and Elbow Surgeons Score(WMD=-0.93;95%CI(-3.83,1.97);P=0.53),VAS pain score(WMD=0.00;95%CI;(-0.17,0.17);P=1.00), range of motion- anteflexion(WMD=1.63;95%CI(-1.36,4.62);P=0.29),range of motion- external rotation(WMD=-028;95%CI(-5.39,5.96);P=0.53),the retear rate(OR=1.57,95% CI(0.87,2.82),P=0.14), at the end of follow-up there was also no significant difference in VAS pain score in the early phase between the 2 repairs.Conclusion:On the basis of current literature, both mini-open and arthroscopic approaches to rotator cuff repair have been confirmed to achieve satisfactory outcomes. But arthroscopic surgery has less soft tissue injuries, extremely low risk of deltoid splitting, more beautiful incision. It depends on usual practice and technical proficiency.