Outcomes of partial vs. complete repair for large to massive rotator cuff tears: a systematic review and meta-analysis.

Background: Large to massive rotator cuff tears are challenging to repair, with partial and complete techniques showing variable outcomes. The purpose of this study is to systematically compare clinical, functional, and structural outcomes following partial and complete repairs. Methods: This Preferred Reporting Items for Systematic Reviews and Meta-Analyses‑compliant systematic review screened MEDLINE, Embase, and Cochrane Central Register of Controlled Trials through June 15, 2025. Study quality was assessed using Risk Of Bias In Non-randomized Studies of Interventions. Included studies involved patients with large (≥ 3 cm) or massive (≥ 5 cm, ≥ 2 tendons, or ≥ 30 cm Results: Nine studies with 508 patients (220 partial and 288 complete repairs) met inclusion criteria. Complete repair demonstrated greater post-operative strength recovery (standardized mean difference = -0.363, 95% confidence interval: [-0.685, 0.042], Conclusion: In comparative studies of large-to-massive rotator cuff tears, partial repair achieved clinical improvement comparable to complete repair across most patient-reported and range-of-motion outcomes. Complete repair showed modest but consistently superior outcomes in post-operative strength recovery, whereas differences in composite functional scores were less consistent and sensitive to between-study heterogeneity and tear-severity mix. Interpretation of these findings is further limited by tear characteristics and reparability which heavily influenced the repair strategy implemented. Accordingly, these findings should not be interpreted as evidence of equivalence between repair techniques in otherwise repairable tears.