Abstract：
BACKGROUND: The purpose of this study is to perform a systematic review of the literature evaluating the importance of subscapularis repair in patients who underwent reverse shoulder arthroplasty (RSA).
METHODS: A systematic search of articles in PubMed, EMBASE, and the Cochrane Library databases was carried out according to the PRISMA guidelines. Cohort studies comparing RSA with subscapularis repair vs. RSA without subscapularis repair were included. All statistical analysis was performed using Review Manager. A P value of <.05 was considered to be statistically significant.
RESULTS: Seventeen studies with 2620 patients were included. Subscapularis repair resulted in less instability compared to without subscapularis repair (0.8% vs. 4.2%, P = .04), and there were no significant differences in rate of instability with lateralization (0.6% vs. 1.6%, P = .40), revision rates (2.6% vs. 3.9%, P = .62), and complication rates (7.7% vs. 4.9%, P = .21). Subscapularis repair had improved American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores (83.6 vs. 80.2, P = .02) and Constant scores (72.6 vs. 68.9, P < .01) but there was not a significant difference in visual analog scale pain scores (1.2 vs. 1.6, P = .11). Subscapularis repair had a significant difference in forward flexion (140° vs. 137°, P = .04) and internal rotation score (5.5 vs. 4.6, P = .001); however, there was no significant difference in external rotation (35° vs. 35°, P = .80) and abduction (117° vs. 123°, P = .13).
CONCLUSIONS: This study found that RSA with subscapularis repair demonstrated a reduction in the occurrence of implant instability with medialized implants. However, subscapularis repair did not yield improvements in revision rates, complications, or instability with lateralized implants. Additionally, other outcome measures such as ASES, Constant score, and range of motion exhibited statistically significant improvements with subscapularis repair but did not surpass clinically significant thresholds.
METHODS: A systematic search of articles in PubMed, EMBASE, and the Cochrane Library databases was carried out according to the PRISMA guidelines. Cohort studies comparing RSA with subscapularis repair vs. RSA without subscapularis repair were included. All statistical analysis was performed using Review Manager. A P value of <.05 was considered to be statistically significant.
RESULTS: Seventeen studies with 2620 patients were included. Subscapularis repair resulted in less instability compared to without subscapularis repair (0.8% vs. 4.2%, P = .04), and there were no significant differences in rate of instability with lateralization (0.6% vs. 1.6%, P = .40), revision rates (2.6% vs. 3.9%, P = .62), and complication rates (7.7% vs. 4.9%, P = .21). Subscapularis repair had improved American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES) scores (83.6 vs. 80.2, P = .02) and Constant scores (72.6 vs. 68.9, P < .01) but there was not a significant difference in visual analog scale pain scores (1.2 vs. 1.6, P = .11). Subscapularis repair had a significant difference in forward flexion (140° vs. 137°, P = .04) and internal rotation score (5.5 vs. 4.6, P = .001); however, there was no significant difference in external rotation (35° vs. 35°, P = .80) and abduction (117° vs. 123°, P = .13).
CONCLUSIONS: This study found that RSA with subscapularis repair demonstrated a reduction in the occurrence of implant instability with medialized implants. However, subscapularis repair did not yield improvements in revision rates, complications, or instability with lateralized implants. Additionally, other outcome measures such as ASES, Constant score, and range of motion exhibited statistically significant improvements with subscapularis repair but did not surpass clinically significant thresholds.
摘要：
目的：本研究的目的是对评估肩胛骨下修复在接受反向肩关节置换术（RSA）的患者中的重要性的文献进行系统回顾。
方法：对Pubmed，EMBASE,Cochrane图书馆数据库是根据PRISMA指南进行的。纳入了队列研究，比较了带肩胛骨下修复的RSA与不带肩胛骨下修复的RSA。使用ReviewManager进行所有统计分析。<0.5的p值被认为是统计学上显著的。
结果：纳入了17项研究，共2620名患者。与没有肩胛骨下修复相比，肩胛骨下修复导致的不稳定性较小（0.8％vs4.2％，p=0.04），并且不稳定率与侧向化没有显着差异（0.6％对1.6％，p=0.40)，修订率（2.6%对3.9%，p=0.62）和并发症发生率（7.7％vs4.9％，p=0.21）。肩胛骨下修复的ASES评分（83.6vs80.2，p=0.02）和恒定评分（72.6vs68.9，p<0.01），但VAS疼痛评分没有显着差异（1.2vs1.6，p=0.11）。肩胛骨下修复前屈有显著差异(140°vs137°,p=0.04）和内部旋转评分（5.5vs4.6p=0.001），但是外部旋转没有显着差异（35°vs35°，p=0.80）和外展（117°vs123°，p=0.13）。
结论：这项研究发现，肩胛骨下修复的RSA证明了使用中介植入物的植入物不稳定的发生减少。然而,肩胛骨下修复没有改善翻修率，并发症,或不稳定与侧向植入物。此外,其他结果指标，如ASES，恒定的分数，肩胛骨下修复术和活动范围显示出统计学上的显着改善，但未超过临床上的显着阈值。
方法：对Pubmed，EMBASE,Cochrane图书馆数据库是根据PRISMA指南进行的。纳入了队列研究，比较了带肩胛骨下修复的RSA与不带肩胛骨下修复的RSA。使用ReviewManager进行所有统计分析。<0.5的p值被认为是统计学上显著的。
结果：纳入了17项研究，共2620名患者。与没有肩胛骨下修复相比，肩胛骨下修复导致的不稳定性较小（0.8％vs4.2％，p=0.04），并且不稳定率与侧向化没有显着差异（0.6％对1.6％，p=0.40)，修订率（2.6%对3.9%，p=0.62）和并发症发生率（7.7％vs4.9％，p=0.21）。肩胛骨下修复的ASES评分（83.6vs80.2，p=0.02）和恒定评分（72.6vs68.9，p<0.01），但VAS疼痛评分没有显着差异（1.2vs1.6，p=0.11）。肩胛骨下修复前屈有显著差异(140°vs137°,p=0.04）和内部旋转评分（5.5vs4.6p=0.001），但是外部旋转没有显着差异（35°vs35°，p=0.80）和外展（117°vs123°，p=0.13）。
结论：这项研究发现，肩胛骨下修复的RSA证明了使用中介植入物的植入物不稳定的发生减少。然而,肩胛骨下修复没有改善翻修率，并发症,或不稳定与侧向植入物。此外,其他结果指标，如ASES，恒定的分数，肩胛骨下修复术和活动范围显示出统计学上的显着改善，但未超过临床上的显着阈值。
