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Apollo
By Dave Osinachukwu Duru and David Kwan Ryung Lee.
To evaluate the clinical and structural outcomes of arthroscopic partial repair (APR), performed with and without human acellular dermal matrix (ADM), in patients with massive irreparable rotator cuff tears (MIRCTs).
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In accordance with PRISMA guidelines, MEDLINE, Embase, and the Cochrane Library were searched from inception to November 2025. Eligible studies included randomized controlled trials, cohort studies, and case series (>10 patients) reporting outcomes of APR with or without ADM, with minimum 12-month follow-up. Two reviewers independently extracted data and assessed study quality using Cochrane Risk of Bias 2.0 (RoB 2.0) and Methodological Index for Non-Randomized Studies (MINORS) tools.
Forty-five studies, encompassing 1581 patients, met the inclusion criteria. Both APR alone and APR with ADM were associated with significant improvements in pain and functional outcomes. Similar ranges of improvement in American Shoulder and Elbow Surgeons (ASES), Disabilities of the Arm, Shoulder and Hand (DASH), and Constant-Murley (CM) scores were observed with and without ADM. Where reported, patient-level minimal clinically important difference (MCID) achievement ranged from 70 to 94% for ASES and CM after APR and 83 to 88.9% for DASH following ADM. APR with ADM may be associated with lower retear rates compared with APR alone. Other reported complication rates were low for both techniques.
APR, with or without ADM, is an effective joint-preserving treatment option for MIRCTs, providing significant improvements in pain and function, with low complication rates. While ADM may enhance the structural durability of the repair construct, clear superiority in patient-reported outcomes has not been established.
Published in Apollo (University of Cambridge). The abstract is shown as published and remains the work of its authors; read the full article at the source.
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