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关节镜下与小切口开放性肩袖修补术:随机对照试验的最新荟萃分析

Arthroscopic versus mini-open rotator cuff repair: an up-to-date meta-analysis of randomized controlled trials.

作者信息

Ji Xiaoxi, Bi Chun, Wang Fang, Wang Qiugen

机构信息

Orthopaedic Traumatology Department, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

Orthopaedic Traumatology Department, Shanghai First People's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.

出版信息

Arthroscopy. 2015 Jan;31(1):118-24. doi: 10.1016/j.arthro.2014.08.017. Epub 2014 Oct 16.

Abstract

PURPOSE

The aim of this meta-analysis was to compare the clinical outcomes of arthroscopic and mini-open rotator cuff repairs based on recently published Level I randomized controlled trials (RCTs).

METHODS

We systematically searched electronic databases to identify RCTs that compared arthroscopic and mini-open rotator cuff repairs from 1980 to October 2013. The clinical outcome scores, including the University of California, Los Angeles score and the Constant-Murley score, were converted to a common 100-point outcome score for further analysis. The results of the pooled studies were analyzed in terms of surgery time, weighted 100-point score, pain on a visual analog scale (VAS), and range of motion. Study quality was assessed and relevant data were extracted independently by 2 reviewers.

RESULTS

Five RCTs, including 166 patients in the arthroscopic repair group and 163 patients in the mini-open repair group, were included in this meta-analysis. The results of the meta-analysis showed that there were no significant differences in surgery time (P = .11), weighted 100-point score (P = .65), VAS pain score (P = .87), or range of motion (P = .29 for forward flexion and P = .82 for external rotation).

CONCLUSIONS

On the basis of current literature, no differences in surgery time, functional outcome score, VAS pain score, and range of motion were found at the end of follow-up between the arthroscopic and mini-open rotator cuff repair techniques. In addition, there was no significant difference in VAS pain score in the early phase between the 2 repairs.

LEVEL OF EVIDENCE

Level I, meta-analysis of Level I studies.

摘要

目的

本荟萃分析旨在基于近期发表的I级随机对照试验(RCT)比较关节镜下与小切口开放性肩袖修补术的临床疗效。

方法

我们系统检索电子数据库,以确定1980年至2013年10月期间比较关节镜下与小切口开放性肩袖修补术的RCT。将临床疗效评分,包括加利福尼亚大学洛杉矶分校评分和Constant-Murley评分,转换为通用的100分疗效评分以进行进一步分析。汇总研究的结果从手术时间、加权100分评分、视觉模拟量表(VAS)疼痛评分和活动范围方面进行分析。研究质量由2名评审员独立评估并提取相关数据。

结果

本荟萃分析纳入了5项RCT,其中关节镜修补组166例患者,小切口开放性修补组163例患者。荟萃分析结果显示,手术时间(P = 0.11)、加权100分评分(P = 0.65)、VAS疼痛评分(P = 0.87)或活动范围(前屈P = 0.29,外旋P = 0.82)方面均无显著差异。

结论

基于当前文献,在随访结束时,关节镜下与小切口开放性肩袖修补技术在手术时间、功能疗效评分、VAS疼痛评分和活动范围方面均无差异。此外,两种修补术在早期VAS疼痛评分方面也无显著差异。

证据级别

I级,I级研究的荟萃分析。

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