DOI: 10.4103/ijors.ijors_26_25 ISSN: 2773-1367

Comparative Analysis of Re-tear Rates Following Rotator Cuff Repair: Knotless SpeedBridge with Suture Tapes versus Traditional Repair Methods—A Systematic Review and Meta-Analysis

Ramkinkar Jha, Raman Kant Aggarwal, Chantelle Aftab, Mohd Irfan Banday

Abstract

Background:

Rotator cuff tears represent a frequent cause of shoulder dysfunction, with re-tear rates after surgical repair ranging from 20% to 94%. The knotless SpeedBridge technique utilising suture tapes may improve repair integrity through enhanced tendon compression and elimination of knot-related complications compared to traditional methods.

Purpose:

To systematically compare imaging-confirmed re-tear rates between SpeedBridge and traditional rotator cuff repair methods through a comprehensive meta-analysis.

Materials and Methods:

Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, systematic searches of MEDLINE, EMBASE, Web of Science, Cochrane Library, CINAHL and SPORTDiscus were conducted through January 2024. Randomised controlled trials and observational comparative studies examining primary full-thickness rotator cuff repairs with ≥12 months imaging follow-up were included. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using random-effects meta-analysis. The study quality was assessed using Cochrane Risk of Bias 2 for randomised controlled trials (RCTs) and Newcastle–Ottawa Scale for observational studies.

Results:

Sixteen studies comprising 1492 patients (5 RCTs and 11 observational) met inclusion criteria. SpeedBridge repairs demonstrated significantly lower re-tear rates compared to traditional methods (RR 0.64, 95% CI: 0.52–0.79, P < 0.001; I 2 = 42%). Subgroup analysis revealed pronounced benefits in large/massive tears (RR 0.53; number needed to treat [NNT] = 4) versus small/medium tears (RR 0.78; NNT = 12). Secondary outcomes included modest functional improvements and reduced medial cuff failure rates. Grading of Recommendations Assessment, Development and Evaluation evidence quality was moderate.

Conclusions:

The Knotless SpeedBridge technique significantly reduces re-tear risk by 36% compared to traditional repairs, with greatest benefits in large and massive tears. These findings support the use of SpeedBridge as the preferred technique for complex rotator cuff reconstructions.

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