Efficacy and safety of bone channeling in arthroscopic rotator cuff repair: a meta-analysis_West China Medical Journal

Authors：

 LIU Kai ¹ , ZHANG Huiwei ² , WANG Yongcai ¹

1. Department of Orthopedics, People’s Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;
2. Department of Anaesthesia, People’s Hosipital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

LIU Kai, Email: 285061643@qq.com

Keywords：

Bone channeling; rotator cuff injury; microfracture

DOI：

10.7507/1002-0179.202409134

Video：

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Objective To study the efficacy and safety of bone channeling in arthroscopic rotator cuff repair. Methods China National Knowledge Infrastructure, Cochrane Library, Chongqing VIP, PubMed, Wanfang database and Embase were searched to collect all randomized controlled trials of the application of bone channeling in arthroscopic rotator cuff repair. The search time was from the establishment of databases to October 15, 2025. RevMan 5.3 software was used for meta-analysis to explore the differences in postoperative functional score, pain, complications, reoperation and 2-year postoperative re-tear between the bone channeling group and the control group. Results Nine randomized controlled trial studies were finally included. The results of meta-analysis showed that there were no significant differences in the postoperative Constant Function Score [mean difference (MD)=1.27], American Shoulder and Elbow Surgeons score (MD=1.26), postoperative pain score (MD=0.27), 2-year postoperative incidence of re-tear [relative risk (RR)=1.22], reoperation rate (RR=1.19) and complication rate (RR=1.37) between the bone channeling group and the control group (P>0.05). Conclusions Existing evidence shows that the application of bone channeling in arthroscopic rotator cuff repair failed to improve the postoperative re-tear of patients, but also did not lead to pain and complications.

Citation： LIU Kai, ZHANG Huiwei, WANG Yongcai. Efficacy and safety of bone channeling in arthroscopic rotator cuff repair: a meta-analysis. West China Medical Journal, 2025, 40(10): 1606-1610. doi: 10.7507/1002-0179.202409134 Copy

1.	Darbandi AD, Cohn M, Credille K, et al. A systematic review and meta-analysis of risk factors for the increased incidence of revision surgery after arthroscopic rotator cuff repair. Am J Sports Med, 2024, 52(5): 1374-1383.
2.	Arroyo W, Getelman MH, Snyder SJ. Single row rotator cuff repair with triple loaded suture anchors: the SCOI row technique. Arthroscopy, 2021, 37(8): 2397-2398.
3.	Sun Y, Kwak JM, Kholinne E, et al. Small subchondral drill holes improve marrow stimulation of rotator cuff repair in a rabbit model of chronic rotator cuff tear. Am J Sports Med, 2020, 48(3): 706-714.
4.	Bilsel K, Yildiz F, Kapicioglu M, et al. Efficacy of bone marrow-stimulating technique in rotator cuff repair. J Shoulder Elbow Surg, 2017, 26(8): 1360-1366.
5.	Khangura S, Konnyu K, Cushman R, et al. Evidence summaries: the evolution of a rapid review approach. Syst Rev, 2012, 1: 10.
6.	Milano G, Saccomanno MF, Careri S, et al. Efficacy of marrow-stimulating technique in arthroscopic rotator cuff repair: a prospective randomized study. Arthroscopy, 2013, 29(5): 802-810.
7.	Osti L, Del Buono A, Maffulli N. Microfractures at the rotator cuff footprint: a randomised controlled study. Int Orthop, 2013, 37(11): 2165-2171.
8.	Ruiz Ibán MA, Sanchez Alepuz E, Diaz Heredia J, et al. Footprint preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc, 2021, 29(7): 2249-2256.
9.	Lapner P, Pollock JW, Laneuville O, et al. Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial. Bone Joint J, 2021, 103(1): 123-130.
10.	秦立友, 朱波涛, 卞伟伟. 关节镜下不同治疗方案在全层大肩袖损伤老年患者中的应用. 海南医学, 2021, 32(19): 2511-2514.
11.	Toro F, Pinochet F, Ruiz F, et al. Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial. J Shoulder Elbow Surg, 2022, 31(6): 1200-1207.
12.	Lapner P, Bouliane M, Pollock JW, et al. Intraoperative channeling in arthroscopic rotator cuff repair: a multicenter randomized controlled trial. Am J Sports Med, 2023, 51(2): 323-330.
13.	Shibata T, Izaki T, Miyake S, et al. Efficacy of bone marrow stimulation for arthroscopic knotless suture bridge rotator cuff repair: a prospective randomized controlled trial. J Shoulder Elbow Surg, 2023, 32(5): 909-916.
14.	Hong KB, Lee TH, Park HK, et al. The impact of bone marrow stimulation on arthroscopic rotator cuff repair for small to large rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg, 2024, 33(10): 2130-2141.
15.	Kavanagh DP, Robinson J, Kalia N. Mesenchymal stem cell priming: fine-tuning adhesion and function. Stem Cell Rev Rep, 2014, 10(4): 587-599.
16.	Bagge J, Berg LC, Janes J, et al. Donor age effects on in vitro chondrogenic and osteogenic differentiation performance of equine bone marrow- and adipose tissue-derived mesenchymal stromal cells. BMC Vet Res, 2022, 18(1): 388.
17.	Muench LN, Baldino JB, Berthold DP, et al. Subacromial bursa-derived cells demonstrate high proliferation potential regardless of patient demographics and rotator cuff tear characteristics. Arthroscopy, 2020, 36(11): 2794-2802.
18.	Kim C, Lee YJ, Kim SJ, et al. Bone marrow stimulation in arthroscopic repair for large to massive rotator cuff tears with incomplete footprint coverage. Am J Sports Med, 2020, 48(13): 3322-3327.
19.	Cole BJ, Kaiser JT, Wagner KR, et al. Prospective randomized trial of biologic augmentation with bone marrow aspirate concentrate in patients undergoing arthroscopic rotator cuff repair. Am J Sports Med, 2023, 51(5): 1234-1242.
20.	Seow D, Yasui Y, Hutchinson ID, et al. The subchondral bone is affected by bone marrow stimulation: a systematic review of preclinical animal studies. Cartilage, 2019, 10(1): 70-81.
21.	Lee YJ, Chang HH, Lim JR, et al. Medium-sized rotator cuff tears repaired with transosseous-equivalent technique plus bone marrow stimulation yielded similar short-term outcomes regardless of whether complete or incomplete footprint coverage was achieved. Arthroscopy, 2025, 41(7): 2262-2268.

1. Darbandi AD, Cohn M, Credille K, et al. A systematic review and meta-analysis of risk factors for the increased incidence of revision surgery after arthroscopic rotator cuff repair. Am J Sports Med, 2024, 52(5): 1374-1383.
2. Arroyo W, Getelman MH, Snyder SJ. Single row rotator cuff repair with triple loaded suture anchors: the SCOI row technique. Arthroscopy, 2021, 37(8): 2397-2398.
3. Sun Y, Kwak JM, Kholinne E, et al. Small subchondral drill holes improve marrow stimulation of rotator cuff repair in a rabbit model of chronic rotator cuff tear. Am J Sports Med, 2020, 48(3): 706-714.
4. Bilsel K, Yildiz F, Kapicioglu M, et al. Efficacy of bone marrow-stimulating technique in rotator cuff repair. J Shoulder Elbow Surg, 2017, 26(8): 1360-1366.
5. Khangura S, Konnyu K, Cushman R, et al. Evidence summaries: the evolution of a rapid review approach. Syst Rev, 2012, 1: 10.
6. Milano G, Saccomanno MF, Careri S, et al. Efficacy of marrow-stimulating technique in arthroscopic rotator cuff repair: a prospective randomized study. Arthroscopy, 2013, 29(5): 802-810.
7. Osti L, Del Buono A, Maffulli N. Microfractures at the rotator cuff footprint: a randomised controlled study. Int Orthop, 2013, 37(11): 2165-2171.
8. Ruiz Ibán MA, Sanchez Alepuz E, Diaz Heredia J, et al. Footprint preparation with nanofractures in a supraspinatus repair cuts in half the retear rate at 1-year follow-up. A randomized controlled trial. Knee Surg Sports Traumatol Arthrosc, 2021, 29(7): 2249-2256.
9. Lapner P, Pollock JW, Laneuville O, et al. Preoperative bone marrow stimulation does not improve functional outcomes in arthroscopic cuff repair: a prospective randomized controlled trial. Bone Joint J, 2021, 103(1): 123-130.
10. 秦立友, 朱波涛, 卞伟伟. 关节镜下不同治疗方案在全层大肩袖损伤老年患者中的应用. 海南医学, 2021, 32(19): 2511-2514.
11. Toro F, Pinochet F, Ruiz F, et al. Functional and radiologic results of the crimson duvet procedure in rotator cuff treatment: a randomized controlled clinical trial. J Shoulder Elbow Surg, 2022, 31(6): 1200-1207.
12. Lapner P, Bouliane M, Pollock JW, et al. Intraoperative channeling in arthroscopic rotator cuff repair: a multicenter randomized controlled trial. Am J Sports Med, 2023, 51(2): 323-330.
13. Shibata T, Izaki T, Miyake S, et al. Efficacy of bone marrow stimulation for arthroscopic knotless suture bridge rotator cuff repair: a prospective randomized controlled trial. J Shoulder Elbow Surg, 2023, 32(5): 909-916.
14. Hong KB, Lee TH, Park HK, et al. The impact of bone marrow stimulation on arthroscopic rotator cuff repair for small to large rotator cuff tears: a randomized controlled trial. J Shoulder Elbow Surg, 2024, 33(10): 2130-2141.
15. Kavanagh DP, Robinson J, Kalia N. Mesenchymal stem cell priming: fine-tuning adhesion and function. Stem Cell Rev Rep, 2014, 10(4): 587-599.
16. Bagge J, Berg LC, Janes J, et al. Donor age effects on in vitro chondrogenic and osteogenic differentiation performance of equine bone marrow- and adipose tissue-derived mesenchymal stromal cells. BMC Vet Res, 2022, 18(1): 388.
17. Muench LN, Baldino JB, Berthold DP, et al. Subacromial bursa-derived cells demonstrate high proliferation potential regardless of patient demographics and rotator cuff tear characteristics. Arthroscopy, 2020, 36(11): 2794-2802.
18. Kim C, Lee YJ, Kim SJ, et al. Bone marrow stimulation in arthroscopic repair for large to massive rotator cuff tears with incomplete footprint coverage. Am J Sports Med, 2020, 48(13): 3322-3327.
19. Cole BJ, Kaiser JT, Wagner KR, et al. Prospective randomized trial of biologic augmentation with bone marrow aspirate concentrate in patients undergoing arthroscopic rotator cuff repair. Am J Sports Med, 2023, 51(5): 1234-1242.
20. Seow D, Yasui Y, Hutchinson ID, et al. The subchondral bone is affected by bone marrow stimulation: a systematic review of preclinical animal studies. Cartilage, 2019, 10(1): 70-81.
21. Lee YJ, Chang HH, Lim JR, et al. Medium-sized rotator cuff tears repaired with transosseous-equivalent technique plus bone marrow stimulation yielded similar short-term outcomes regardless of whether complete or incomplete footprint coverage was achieved. Arthroscopy, 2025, 41(7): 2262-2268.

West China Medical Journal

Efficacy and safety of bone channeling in arthroscopic rotator cuff repair: a meta-analysis

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