Purpose
To compare knotted and knotless transosseous equivalent (TOE) rotator cuff repair
(RCR) techniques and evaluate their imaging-diagnosed retear rates.
Methods
The Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled
Trials, PubMed (2008 to 2019), EMBASE (2008 to 2019), and Medline (2008 to 2019) were
used to perform a systematic review and meta-analysis using the PRISMA (Preferred
Reporting Items for Systematic Reviews and Meta-Analyses) criteria, with the following
search terms: rotator cuff repair AND (knotless OR knotted) AND transosseous; rotator
cuff repair AND (knotless OR knotted or transosseous); rotator cuff repair AND (“suture
bridge” OR “suture bridging”). Data pertaining to demographic characteristics, surgical
techniques, retears, and patient-reported outcomes were extracted from each study.
Rates and locations of retear were reported using ranges, and risks of bias and heterogeneity
for each study were assessed.
Results
A total of 7 studies (552 shoulders) were included. Patients had a weighted mean (±
standard deviation) age of 60.5 ± 2.4 years with 27.8 ± 7.9-month follow-up. The incidence
of retears ranged from 5.1% to 33.3% in patients treated with knotless TOE RCR, and
the incidence for patients treated with knotted TOE RCR ranged from 7.5% to 25%. The
incidence of type I retears ranged from 42.9% to 100% for patients treated with knotless
TOE RCR and 20% to 100% for patients treated with knotted TOE RCR. The incidence of
type II retears ranged from 0% to 57.1% in patients treated with knotless TOE RCR
and 0% to 100% in patients treated with knotted TOE RCR.
Conclusions
The incidence and location of retears after knotless and knotted TOE RCR appear to
be similar.
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Article info
Publication history
Published online: February 10, 2020
Accepted:
January 31,
2020
Received:
September 9,
2019
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
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© 2020 by the Arthroscopy Association of North America
