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O reparo do manguito rotador artroscópico e mini-aberto produz resultados clínicos e estruturais comparáveis em lágrimas de espessura total de pequeno a médio: revisão sistemática e metanálise da importância de ensaios controlados randomizados

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Imagem de arquivo, ilustrativa — não é do estudo. Osso compacto humano em corte transversal, ao microscópio óptico. Berkshire Community College Bioscience Image Library · CC0 · Wikimedia Commons

MetanáliseNível 1 · Evidência consolidadaJournal of ISAKOS : joint disorders & orthopaedic sports medicine4 ago 20260 citações

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Resumo original em inglês

O que aconteceu

Arthroscopic rotator cuff repair (ARR) and mini-open rotator cuff repair (MRR) are both widely used, but whether ARR offers clinical advantages over MRR remains uncertain.

The aim of this study was to compare the clinical and structural outcomes of ARR and MRR in adult patients with rotator cuff tears.

A systematic search of PubMed, Scopus, and the Cochrane Library was performed from inception to November 2025 for randomized controlled trials (RCTs) directly reporting functional score, shoulder range of motion (ROM), re-tear rate, pain, or complications with a minimum follow-up of 6 months. Random-effect models pooled standardized mean differences (SMDs) for functional scores; mean differences (MDs) for ROM and pain; and risk ratios (RRs) for dichotomous outcomes, each with 95% confidence intervals (CIs).

I-II, systematic review and meta-analysis of RCTs).

O que encontraram

Seven studies (725 shoulders) were included, predominantly involving small- to medium-sized full-thickness tears. Functional outcomes did not differ between ARR and MRR at 3, 6, or 12 months (SMD range: -0.26 to 0.33; p ≥ 0.53). Pain measured using the visual analog scale was comparable at 3 and 6 months, with minimal between-group differences (MD < 0.1 points; p ≥ 0.82). ROM was also comparable at 6 and 12 months for both forward flexion and external rotation, with small pooled differences (MD < 2°; p ≥ 0.18). There were no statistically significant differences in re-tear rates (RR: 1.28, 95% CI: 0.87 to 1.86, p = 0.21), postoperative stiffness (RR: 0.86, 95% CI: 0.47 to 1.60, p = 0.64), or infection (RR: 0.19, 95% CI: 0.02 to 1.59, p = 0.12).

Por que isso importa

ARR and MRR yielded comparable functional recovery, pain relief, structural integrity, and complication rates. Current evidence does not support the superiority of either technique. Technique selection should be individualized to tear characteristics, surgeon expertise, and resource availability.

Resumo publicado sob licença CC BY. A tradução para o português ainda não chegou a este estudo.

O estudo original

Arthroscopic and mini-open rotator cuff repair yield comparable clinical and structural outcomes in small to medium full-thickness tears: a systematic review and meta-analysis of randomized controlled trials' importance

Chulayut Yuwarungsikul, Krittapas Mathurunyanont, Jirut Sirisoonthron, Potsawat Veerathumjumras, Napatpong Thamrongskulsiri, Danaithep Limskul, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Thun Itthipanichpong

Descritores MeSH

  • Arthroscopy
  • Rotator Cuff
  • Rotator Cuff Injuries
  • Range of Motion, Articular
  • Treatment Outcome
  • Recovery of Function
  • Humans
  • Randomized Controlled Trials as Topic

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