Summary

Reduced Retear Rates Yet Similar Clinical Outcomes Following Arthroscopic Rotator Cuff Repair with Biceps Augmentation Compared to Repairs Without Biceps Augmentation

Abstract

Purpose

This study aimed to compare the clinical outcomes and retear rates between arthroscopic rotator cuff repair with BA and PR without BA, specifically focusing on large to massive tears.

Methods

The study was registered on PROSPERO with the registration number CRD42024505059. The search adhered to the 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Inclusion criteria encompassed studies comparing the outcomes of arthroscopic repair for large to massive rotator cuff tears with and without the BA technique, with a specific focus on postoperative clinical results and retear rates. Mean differences were used to express continuous outcomes, while odds ratios were employed for dichotomous outcomes.

Results

Included were 10 studies comprising 733 shoulders, all classified as level 3 evidence. The BA group exhibited a significant reduction in retear rates (OR = 0.40, 95% CI: 0.20 to 0.77, p-value = 0.007), while demonstrating comparable postoperative outcomes across various measures: ASES score (MD = 0.28, 95% CI: -2.88 to 3.44, p-value = 0.86), Constant score (MD = -0.01, 95% CI: -1.87 to 1.86, p-value = 1.00), VAS for pain (MD = -0.13, 95% CI: -0.34 to 0.08, p-value = 0.24), UCLA shoulder score (MD = 0.74, 95% CI: -0.87 to 2.35, p-value = 0.37), active forward flexion motion (MD = 1.27, 95% CI: -4.38 to 6.92, p-value = 0.66), and active external rotation at the arm-at-side position (MD = -1.39, 95% CI: -4.78 to 1.99, p-value = 0.42) compared to the PR group.

Conclusion

Arthroscopic rotator cuff repair with BA for large to massive rotator cuff tears is both a reliable technique, leading to improved postoperative outcomes. The BA group demonstrated similar clinical outcomes and range of motion but with lower retear rates when compared to the PR group.

Level of evidence: Level 3