Rotator cuff tears are common in clinical practice, resulting in persistent shoulder pain and decreased joint motion. Foreign data show that the annual outpatient volume of rotator cuff diseases is more than 4.5 million cases, and the annual operation volume is about 40,000. Rotator cuff tear is mainly seen in middle-aged and elderly patients, and its incidence shows a significant increasing trend with age. The surgical treatment of rotator cuff tear can be divided into traditional open repair, arthroscopy-assisted small incision, and total endoscopic surgery. Total mirror surgery has the advantages of small skin incisions and slight tissue damage, but it is difficult to operate and has a long learning curve, and it has been gradually popularized in recent years. With the maturity of arthroscopic technology, full-scope repair of rotator cuff tears has gradually become mainstream, but its clinical effect compared with open repair is still controversial. The meta-analysis papers published in the past comparing full lens versus open incision repair were either carried out early randomized controlled trials (RCTS) not included, or a few RCTS were mixed with observational studies, failed to summarize the best evidence to illustrate the problem.

To evaluate the efficacy and safety of arthroscopic and open rotator cuff repairs in treating rotator cuff tears.

mbase, Medline, Cochrane Library, ClinicalTrials.gov, SinoMed, CNKI, VIP, and Wanfang databases were searched to collect randomized controlled trials (RCT) that compared arthroscopic and open/mini-open rotator cuff repairs from inception to April 2023. The methodological quality of the included study was assessed using the Cochrane Risk Assessment Tool. Meta-analysis was performed using Stata 14.0 software.

Eight studies were included in the meta-analysis, involving 750 patients (378 in the arthroscopic repair group and 372 in the open/mini-open repair group) . There were no significant differences between the two groups in aspects of shoulder function score (SMD = -0.02, 95% CI: -0.19-0.15, P= 0.81) , pain score (SMD = -0.02, 95% CI: -0.18-0.14, P = 0.84) , range of forward flexion (MD = 1.29, 95% CI: -0.71-3.30, P = 0.21) , range of external rotation (MD = -0.31, 95% CI: -3.32-2.69, P = 0.84) , retear rate (RR= 1.22, 95% CI: 0.88-1.68, P = 0.23) and stiffness rate (RR = 0.89, 95% CI: 0.48-1.64, P = 0.71) . In the meantime, the arthroscopic repair group had a longer operation time (MD = 12.12, 95% CI: 2.03-22.21, P = 0.02) compared with the open/mini-open repair group.

The clinical outcomes of rotator cuff tears are similar with total arthroscopy compared with open open/mini-open repair.