Does suprascapular nerve release provide additional benefits for rotator cuff repair: a systematic review and meta-analysis

Hsuan-Hsiao Ma; Wei-Ting Wu; I-Chen Tsai; Ke-Vin Chang

doi:10.1016/j.jse.2022.05.015

Does suprascapular nerve release provide additional benefits for rotator cuff repair: a systematic review and meta-analysis

J Shoulder Elbow Surg. 2022 Nov;31(11):2421-2430. doi: 10.1016/j.jse.2022.05.015. Epub 2022 Jun 20.

Authors

Hsuan-Hsiao Ma¹, Wei-Ting Wu², I-Chen Tsai³, Ke-Vin Chang⁴

Affiliations

¹ Department of Orthopedics and Traumatology, Taipei Veterans General Hospital, Taipei, Taiwan; Department of Orthopedics, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Orthopedics and Traumatology, Taipei Veterans General Hospital Taitung Branch, Taitung, Taiwan.
² Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan.
³ Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Congenital Heart Disease Study Group, Asian Society of Cardiovascular Imaging, Seoul, Republic of Korea; InnovaRad Inc., Taichung, Taiwan.
⁴ Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan; Center for Regional Anesthesia and Pain Medicine, Wang-Fang Hospital, Taipei Medical University, Taipei, Taiwan. Electronic address: kvchang011@gmail.com.

PMID: 35738544
DOI: 10.1016/j.jse.2022.05.015

Abstract

Background: There is still a lack of consensus regarding whether suprascapular nerve decompression should be routinely performed with rotator cuff repair. Therefore, this meta-analysis aimed to evaluate whether additional suprascapular nerve release (SSNR) could improve shoulder functional outcomes and pain relief more than rotator cuff repair alone.

Materials and methods: We performed a literature review of electronic databases for noncomparative and comparative studies investigating the effect of SSNR in patients undergoing rotator cuff repair. The primary outcome was the change in shoulder function scores from the preoperative status, and the secondary outcome was the change in the visual analog scale (VAS) score of pain after surgery. A subgroup analysis was conducted based on the study design (noncomparative studies vs. comparative studies).

Results: Nine studies comprising 279 participants were included. Our analysis demonstrated that the group that underwent SSNR had a better shoulder functional score after surgery than at preoperative assessment (standardized mean difference [SMD], 1.333, 95% confidence interval [CI], 0.708-1.959). No significant differences were identified in shoulder function improvement between those with and without SSNR, with an SMD of 0.163 (95% CI, -0.091 to 0.418). Likewise, the group with SSNR showed a decreased VAS score after surgery compared to their preoperative status (SMD, 0.910; 95% CI, 0.560-1.260). However, there was no significant difference in VAS change between those with and without SSNR, with an SMD of 0.431 (95% CI, -0.095 to 0.956).

Conclusion: The present meta-analysis revealed that SSNR might not be routinely needed in rotator cuff tendon repair as no additional benefits in functional improvement or pain relief were identified compared to rotator cuff tendon repair alone.

Keywords: Arthroscopy; rotator cuff repair; shoulder surgery; suprascapular nerve release.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Arthroscopy / adverse effects
Humans
Pain / etiology
Rotator Cuff Injuries*
Rotator Cuff*
Shoulder
Treatment Outcome