Outcomes comparison of delaminated and nondelaminated rotator cuff tears after arthroscopic repair: a systematic review and meta-analysis

This study aimed to systematically review the literature comparing the structural integrity and clinical outcomes between delaminated and nondelaminated rotator cuff tears after en masse arthroscopic repair. A systematic review of the literature was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A literature search was performed in the electronic databases of PubMed, EMBASE, and the Cochrane Library for published studies reporting clinical and imaging outcomes after surgical repair of tears. Only English-language studies were included. Seven comparative studies were assessed in this review, including 882 (44.5%) shoulders for the delaminated group and 1099 (55.5%) shoulders for the nondelaminated group. For the delaminated and nondelaminated groups, the mean ages were 61.7 and 59.8 years, respectively. The results show a significantly higher rate of complete healing rate in nondelaminated tendons than in delaminated tendons after en masse arthroscopic repair (risk ratio, 0.86; 95% CI, 0.80 to 0.93; p < .0001). Furthermore, pooled data show that partial healing and retear rate are lower in nondelaminated cuff tears than in delaminated tears after arthroscopic repair [(risk ratio, 1.63; 95% CI, 1.26 to 2.10; p = .0002; risk ratio, 1.81; 95% CI, 1.40 to 2.33; p < .00001), respectively]. In addition, functional outcome scores showed no significant difference between both groups. Delaminated tendon tears exhibit poorer complete healing and higher retear rates following en masse repair compared with nondelaminated tears. However, delamination does not appear to influence patient-reported outcome scores or postoperative range of motion.