哪些因素与自体长二头肌肌腱肩部上囊重建术后再破裂有关?-系统检讨。

Zeitschrift fur Orthopadie und Unfallchirurgie Pub Date : 2024-12-01 Epub Date: 2023-11-15 DOI:10.1055/a-2195-0790
Marius von Knoch, Daniel B Hoffmann, Mike H Baums
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引用次数: 0

摘要

在系统回顾的基础上,本研究分析了肩袖重建中自体长二头肌肌腱重建上囊后复发率或不愈合的相关因素。2021年9月,使用PRISMA检查表对美国国家医学图书馆/美国国立卫生研究院(PubMed)数据库和Cochrane图书馆进行了系统审查。文章被识别和分析,包含数据的上囊重建与自体长二头肌肌腱重建肩袖后的再破裂率。目的是确定与再破裂或不愈合相关的因素。偏倚风险采用纽卡斯尔-渥太华量表确定。最初可以产生86个点击。2020年和2021年的7篇文章符合纳入标准,并在内容方面进行了进一步分析。证据等级为III至IV级。随访时间为12个月(最少)至24至48个月。偏倚的风险并不低。糖尿病和肩胛下肌、冈下肌或小圆肌的高度脂肪变性作为术前因素可能与再破裂或不愈合相关。年龄、足印覆盖百分比、撕裂大小、症状持续时间、束数、肩峰成形术和撕裂形态不是显著因素。性别、冈上肌脂肪变性程度和肩胛下肌肌腱病变程度评分不同。根据文献,但目前仍处于短期观察期,如果肩胛下肌、棘下肌或小圆肌没有高度脂肪变性,自体长二头肌肌腱的上囊重建术是大量撕裂和老年患者的另一种治疗选择。糖尿病预后不良。到目前为止,额外的肩峰成形术并没有带来更好的结果。
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Which Factors Are Associated With Rerupture After Superior Capsular Reconstruction of the Shoulder With Autologous Long Biceps Tendon? - A Systematic Review.

Based on a systematic review, the present work analyses factors associated with the rerupture rate or non-healing after superior capsular reconstruction with autologous long biceps tendon in the reconstruction of the rotator cuff of the shoulder.A systematic review of the U.S. National Library of Medicine/National Institutes of Health (PubMed) database and the Cochrane Library was conducted in September 2021 using the PRISMA checklist. Articles were identified and analysed that contained data on the rerupture rate after superior capsular reconstruction with autologous long biceps tendon in reconstruction of the rotator cuff of the shoulder. The aim was to identify factors associated with rerupture or non-healing. The risk of bias was determined using the Newcastle-Ottawa scale.Primarily 86 hits could be generated. Seven articles from 2020 and 2021 met the inclusion criteria and were further analysed in terms of content. The evidence level was III to IV. Follow-up was between 12 (minimum) and 24 to 48 months. The risk of bias was not low. Factors that may be associated with rerupture or non-healing are diabetes mellitus and high-grade fatty degeneration of the subscapularis, infraspinatus, or teres minor as preoperative factors. Age, percent footprint coverage, tear size, symptom duration, number of bundles, acromioplasty performed, and tear configuration were not significant factors. Gender, degree of fatty degeneration of the supraspinatus and lesions of the subscapularis tendon were rated differently.According to the literature, but still currently with short-term observation periods, superior capsular reconstruction with an autologous long biceps tendon is another treatment option in the case of massive tears and elderly patients, if there is no high-grade fatty degeneration of the subscapularis, infraspinatus or teres minor. Diabetes mellitus has an unfavorable prognosis. Additional acromioplasty has so far not been associated with better outcomes.

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