髋臼成形术联合关节镜下肩袖修复术可降低再次手术的风险:系统综述和荟萃分析。

Postgraduate medicine Pub Date : 2024-08-01 Epub Date: 2024-07-09 DOI:10.1080/00325481.2024.2377533
Jinlong Zhao, Hetao Huang, Lingfeng Zeng, Jianke Pan, Jun Liu, Minghui Luo
{"title":"髋臼成形术联合关节镜下肩袖修复术可降低再次手术的风险:系统综述和荟萃分析。","authors":"Jinlong Zhao, Hetao Huang, Lingfeng Zeng, Jianke Pan, Jun Liu, Minghui Luo","doi":"10.1080/00325481.2024.2377533","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Whether to perform acromioplasty in arthroscopic rotator cuff repair (ARCR) is controversial, and the optimal surgical approach for rotator cuff tear repair is unknown. The purpose of this study was to compare the reoperation rate, retear rate and patient-reported outcomes (PROs) of ARCR with those of ARCR combined with acromioplasty (ARCR-A).</p><p><strong>Methods: </strong>PubMed, Embase and Cochrane Library were searched for relevant literature dated between database inception and 4 December 2023. The primary outcomes of this study were the reoperation rate and the retear rate. The secondary outcomes were PROs, including the visual analogue scale (VAS) pain score, the American Shoulder and Elbow Surgeons (ASES) score, the University of California-Los Angeles (UCLA) score, the Constant score and the Western Ontario Rotator Cuff (WORC) score. The quality of the included studies was evaluated by using the risk of bias assessment tool. RevMan 5.3 software was used for meta-analysis. Fixed (I<sup>2</sup> <50%) or random (I<sup>2</sup> ≥50%) effects models were applied to calculate the effect size.</p><p><strong>Results: </strong>Meta-analysis revealed that ARCR-A had a lower reoperation rate (OR = 0.35, 95%CI: 0.15-0.85, <i>p</i> = 0.02), but the difference in the retear rate between ARCR-A and ARCR was not significant (<i>p</i> = 0.25). In type 2 acromion patients, the reoperation rate was not significantly different between ARCR and ARCR-A (<i>p</i> = 0.12), but, for type 3 acromion patients, the retear rate was lower for ARCR-A than for ARCR (OR = 0.12, 95%CI: 0.01-0.94, <i>p</i> = 0.04). There were statistically significant differences in the 6-month postoperative Constant scores (<i>p</i> < 0.001), VAS pain scores (<i>p</i> = 0.003) 12-month postoperative ASES scores (<i>p</i> = 0.02) and 24-month postoperative WORC scores (<i>p</i> = 0.04), but these differences were not clinically significant.</p><p><strong>Conclusions: </strong>Combining ARCR with acromioplasty can reduce the rate of reoperation, especially in patients with type 3 acromion, but it provides no clinically important change in the retear rate and postoperative PRO compared with ARCR.</p>","PeriodicalId":94176,"journal":{"name":"Postgraduate medicine","volume":null,"pages":null},"PeriodicalIF":0.0000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Acromioplasty combined with arthroscopic rotator cuff repair can reduce the risk of reoperation: a systematic review and meta-analysis.\",\"authors\":\"Jinlong Zhao, Hetao Huang, Lingfeng Zeng, Jianke Pan, Jun Liu, Minghui Luo\",\"doi\":\"10.1080/00325481.2024.2377533\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Whether to perform acromioplasty in arthroscopic rotator cuff repair (ARCR) is controversial, and the optimal surgical approach for rotator cuff tear repair is unknown. The purpose of this study was to compare the reoperation rate, retear rate and patient-reported outcomes (PROs) of ARCR with those of ARCR combined with acromioplasty (ARCR-A).</p><p><strong>Methods: </strong>PubMed, Embase and Cochrane Library were searched for relevant literature dated between database inception and 4 December 2023. The primary outcomes of this study were the reoperation rate and the retear rate. The secondary outcomes were PROs, including the visual analogue scale (VAS) pain score, the American Shoulder and Elbow Surgeons (ASES) score, the University of California-Los Angeles (UCLA) score, the Constant score and the Western Ontario Rotator Cuff (WORC) score. The quality of the included studies was evaluated by using the risk of bias assessment tool. RevMan 5.3 software was used for meta-analysis. Fixed (I<sup>2</sup> <50%) or random (I<sup>2</sup> ≥50%) effects models were applied to calculate the effect size.</p><p><strong>Results: </strong>Meta-analysis revealed that ARCR-A had a lower reoperation rate (OR = 0.35, 95%CI: 0.15-0.85, <i>p</i> = 0.02), but the difference in the retear rate between ARCR-A and ARCR was not significant (<i>p</i> = 0.25). In type 2 acromion patients, the reoperation rate was not significantly different between ARCR and ARCR-A (<i>p</i> = 0.12), but, for type 3 acromion patients, the retear rate was lower for ARCR-A than for ARCR (OR = 0.12, 95%CI: 0.01-0.94, <i>p</i> = 0.04). There were statistically significant differences in the 6-month postoperative Constant scores (<i>p</i> < 0.001), VAS pain scores (<i>p</i> = 0.003) 12-month postoperative ASES scores (<i>p</i> = 0.02) and 24-month postoperative WORC scores (<i>p</i> = 0.04), but these differences were not clinically significant.</p><p><strong>Conclusions: </strong>Combining ARCR with acromioplasty can reduce the rate of reoperation, especially in patients with type 3 acromion, but it provides no clinically important change in the retear rate and postoperative PRO compared with ARCR.</p>\",\"PeriodicalId\":94176,\"journal\":{\"name\":\"Postgraduate medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":0.0000,\"publicationDate\":\"2024-08-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Postgraduate medicine\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1080/00325481.2024.2377533\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/7/9 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"\",\"JCRName\":\"\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Postgraduate medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1080/00325481.2024.2377533","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/9 0:00:00","PubModel":"Epub","JCR":"","JCRName":"","Score":null,"Total":0}
引用次数: 0

摘要

背景:在关节镜下肩袖修复术(ARCR)中是否进行肩峰成形术尚存在争议,肩袖撕裂修复的最佳手术方法尚不清楚。本研究旨在比较 ARCR 与 ARCR 联合肩峰成形术(ARCR-A)的再手术率、再撕裂率和患者报告结果(PROs):方法:检索了 PubMed、Embase 和 Cochrane 图书馆中从数据库开始到 2023 年 12 月 4 日之间的相关文献。本研究的主要结果是再手术率和再撕裂率。次要结果为PROs,包括视觉模拟量表(VAS)疼痛评分、美国肩肘外科医生(ASES)评分、加州大学洛杉矶分校(UCLA)评分、Constant评分和西安大略省肩袖(WORC)评分。纳入研究的质量采用偏倚风险评估工具进行评估。使用RevMan 5.3软件进行荟萃分析。应用固定(I2 2 ≥50%)效应模型计算效应大小:荟萃分析显示,ARCR-A的再手术率较低(OR = 0.35,95%CI:0.15-0.85,p = 0.02),但ARCR-A和ARCR的再撕裂率差异不显著(p = 0.25)。对于2型肩峰突出患者,ARCR和ARCR-A的再手术率差异不显著(p = 0.12),但对于3型肩峰突出患者,ARCR-A的再撕裂率低于ARCR(OR = 0.12,95%CI:0.01-0.94,p = 0.04)。术后6个月的Constant评分(P = 0.003)、术后12个月的ASES评分(P = 0.02)和术后24个月的WORC评分(P = 0.04)差异有统计学意义,但这些差异无临床意义:结论:ARCR与肩峰成形术相结合可降低再次手术率,尤其是对3型肩峰患者而言,但与ARCR相比,其在再次撕裂率和术后PRO方面并无临床意义。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
Acromioplasty combined with arthroscopic rotator cuff repair can reduce the risk of reoperation: a systematic review and meta-analysis.

Background: Whether to perform acromioplasty in arthroscopic rotator cuff repair (ARCR) is controversial, and the optimal surgical approach for rotator cuff tear repair is unknown. The purpose of this study was to compare the reoperation rate, retear rate and patient-reported outcomes (PROs) of ARCR with those of ARCR combined with acromioplasty (ARCR-A).

Methods: PubMed, Embase and Cochrane Library were searched for relevant literature dated between database inception and 4 December 2023. The primary outcomes of this study were the reoperation rate and the retear rate. The secondary outcomes were PROs, including the visual analogue scale (VAS) pain score, the American Shoulder and Elbow Surgeons (ASES) score, the University of California-Los Angeles (UCLA) score, the Constant score and the Western Ontario Rotator Cuff (WORC) score. The quality of the included studies was evaluated by using the risk of bias assessment tool. RevMan 5.3 software was used for meta-analysis. Fixed (I2 <50%) or random (I2 ≥50%) effects models were applied to calculate the effect size.

Results: Meta-analysis revealed that ARCR-A had a lower reoperation rate (OR = 0.35, 95%CI: 0.15-0.85, p = 0.02), but the difference in the retear rate between ARCR-A and ARCR was not significant (p = 0.25). In type 2 acromion patients, the reoperation rate was not significantly different between ARCR and ARCR-A (p = 0.12), but, for type 3 acromion patients, the retear rate was lower for ARCR-A than for ARCR (OR = 0.12, 95%CI: 0.01-0.94, p = 0.04). There were statistically significant differences in the 6-month postoperative Constant scores (p < 0.001), VAS pain scores (p = 0.003) 12-month postoperative ASES scores (p = 0.02) and 24-month postoperative WORC scores (p = 0.04), but these differences were not clinically significant.

Conclusions: Combining ARCR with acromioplasty can reduce the rate of reoperation, especially in patients with type 3 acromion, but it provides no clinically important change in the retear rate and postoperative PRO compared with ARCR.

求助全文
通过发布文献求助,成功后即可免费获取论文全文。 去求助
来源期刊
自引率
0.00%
发文量
0
期刊最新文献
The triglyceride-glucose index as an indicator of latent atherogenicity of the plasma lipid profile in healthy men with normolipidaemia. Pentoxifylline improves anemia through its novel effect on hypoxia-inducible factor-2 alpha in hemodialysis patients: a randomized, double-blind, placebo-controlled clinical trial. The masters athlete and use of antihypertensive medications. Evaluating cardiac electrophysiological markers for predicting arrhythmic risk in hypothyroid patients. SGLT2 inhibitors across the spectrum of chronic kidney disease: a narrative review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1