Periimplant osteolysis does not affect the outcome of rotator cuff repair: a systematic review and meta-analysis

Purpose The goal of this study was to perform a systematic review and meta-analysis to compare the clinical and radiologic outcomes of rotator cuff repair, depending on the presence of developed periimplant osteolysis (PIO) after using suture anchors. Methods The electronic databases of MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials were searched for articles published up until October 2019 to find relevant articles comparing the outcomes of rotator cuff repair between the periimplant osteolysis group and non-periimplant osteolysis group. Data searching, extraction, analysis, and quality assessment were performed according to the Cochrane Collaboration guidelines. The results are presented as risk ratio (RR) for binary outcomes and standardised mean difference (SMD) for continuous outcomes with 95% confidence intervals (CI). Results Six clinical studies were included. No significant differences were found between the group with periimplant osteolysis and the group without periimplant osteolysis regarding retear rate (RR = 1.34; 95% CI 0.93-1.94; I-2 = 28%), postoperative clinical scores (SMD = 0.29; 95% CI - 0.26 to 0.83; I-2 = 80%) and range of motion (ROM); forward flexion (SMD = 0.39; 95% CI - 0.16 to 0.93; I-2 = 0%), external rotation (SMD = - 0.10; 95% CI - 0.64 to 0.45; I-2 = 0%) and internal rotation (SMD = - 0.37; 95% CI - 0.92 to 0.17; I-2 = 0%). Conclusion The presence of periimplant osteolysis after rotator cuff repair with suture anchor does not affect the clinical outcomes such as retear rate, clinical scoring, and ROM. However, as there was no standard consensus on the criteria for evaluating periimplant osteolysis, this result may not fully reflect the effect of periimplant osteolysis depending on its severity.