Study Summary

8 comparative studies including 582 patients with rotator cuff tears were included in this systematic review and meta-analysis comparing arthroscopic transosseous anchorless repair (TOA) vs suture anchor repair (AR). Pooled outcomes of interest included Constant score, American Shoulder and Elbow Surgeons (ASES) score, range of motion (ROM), visual analog scale (VAS) pain score, and retear rates. Meta-analysis demonstrated no significant differences between TOA and AR in functional outcomes, pain scores, or structural integrity. However, TOA was associated with significantly greater improvement in shoulder abduction ROM. Overall, the findings suggest that TOA provides clinical and structural outcomes comparable to anchor-based repair techniques and may serve as a viable alternative in the management of rotator cuff tears.