■肩关节镜手术中肩袖撕裂的脱层发生率为38%至92%。在这种情况下,最常用的是双层(DL)修复和整体(EM)修复。
■使用荟萃分析比较DL与EM修复技术对脱层肩袖撕裂的临床结果。
■系统评价;证据水平,3.
■我们确定了相关研究,比较了PubMed中DL和EM修复脱层肩袖损伤的临床结果,Embase,和PRISMA(系统审查和荟萃分析的首选报告项目)指南之后的Cochrane数据库。主要结果是Constant评分和再撕裂率。此外,我们比较了其他术后肩关节功能评分,肩部运动范围,2种缝合方法之间的视觉模拟量表(VAS)疼痛评分使用荟萃分析。比较了连续结局的平均差异(MD),比较了分类结局的比值比(ORs).
■在最初确定的197项研究中,该分析包括6项研究。Constant评分有显著差异(MD,8.64[95%CI,4.47至12.8];P<.05)和外部旋转(MD,5.10[95%CI,2.63至7.56];P<.05)两种技术之间,DL修复具有优异的结果。两种技术在前屈中没有观察到显著差异(MD,0.62[95%CI,-1.18至2.43];P=.50),VAS疼痛(MD,-0.03[95%CI,-0.34至0.27];P=.84),或再撕率(或,0.73[95%CI,0.37至1.41];P=.35)。
■本综述和荟萃分析的结果表明,就Constant评分和肩关节外旋而言,DL修复比EM修复更有益。
UNASSIGNED: Delamination of rotator cuff tears during arthroscopic shoulder surgery has an incidence of 38% to 92%. Double-layer (DL) repair and en masse (EM) repair are most commonly used in this situation.
UNASSIGNED: To compare the clinical results of the DL versus EM repair techniques for delaminated rotator cuff tears using a meta-analysis.
UNASSIGNED: Systematic
review; level of evidence, 3.
UNASSIGNED: We identified relevant studies comparing the clinical results of DL and EM repair for delaminated rotator cuff injuries in the PubMed, Embase, and Cochrane databases after the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The primary outcomes were the Constant score and retear rate. Additionally, we compared other postoperative shoulder functional scores, shoulder range of motion, and visual analog scale (VAS) pain scores between the 2 suture methods using a meta-analysis. The mean difference (MD) was compared for continuous outcomes, and the odds ratios (ORs) were compared for categorical outcomes.
UNASSIGNED: Of the 197 studies initially identified, 6 studies were included in this analysis. There were significant differences in the Constant score (MD, 8.64 [95% CI, 4.47 to 12.8]; P < .05) and external rotation (MD, 5.10 [95% CI, 2.63 to 7.56]; P < .05) between the 2 techniques, with DL repair having superior outcomes. No significant differences were observed between the 2 techniques in forward flexion (MD, 0.62 [95% CI, -1.18 to 2.43]; P = .50), VAS pain (MD, -0.03 [95% CI, -0.34 to 0.27]; P = .84), or retear rate (OR, 0.73 [95% CI, 0.37 to 1.41]; P = .35).
UNASSIGNED: Results of this
review and meta-analysis suggest that DL repair was more beneficial than EM repair in terms of the Constant score and shoulder external rotation in patients with delaminated rotator cuff injuries.