Surgical repair versus conservative management in degenerative rotator cuff tears: systematic review and meta-analysis

Abstract

Although surgery is generally used to treat acute traumatic rotator cuff tears (RCTs) in young patients, treating degenerative cuff tears remains a challenge for orthopedic surgeons, and no gold standard has been established. This work aims to determine the efficacy of surgical repair versus conservative management in shoulder degenerative RCTs patients. A systematic search was carried out over different medical databases to identify orthopedic surgery studies, which investigated the outcome of the surgical repair versus the conservative management of RCTs patients. We conducted a meta-analysis for the constant and visual analogue scale (VAS) scores as primary outcomes, and on retear (recurrence) rate as a secondary outcome. Seven studies were identified involving 628 patients: 314 in the surgical repair group and 314 in the conservative management group. Our meta-analysis process showed a non-significant difference in mean constant score and VAS score in the surgical repair group compared to the conservative management group (p > 0.05 for each). Also, we found that the overall pooled recurrence rate was 13.2%. This study compared the efficacy and safety of surgical repair versus conservative management in degenerative RCTs. According to our results, there was no difference between both groups in their effect on mean constant score and mean VAS score, also retear after surgical repair may occur at a similar rate. This means that both approaches had a similar efficacy.