Sheth Mihir, Ko Jia-Wei Kevin, Namdari Surena
Department of Orthopaedics, Rothman Institute, Thomas Jefferson University Hospital, Philadelphia, PA.
Am J Orthop (Belle Mead NJ). 2017 Sep/Oct;46(5):E287-E292.
In a systematic review, we critically examined and synthesized the results of individual studies on reverse shoulder arthroplasty (RSA) with latissimus dorsi tendon transfer. Two electronic databases were searched. For each included study, 2 reviewers evaluated the quality of its methods and retrieved data. In cases in which outcomes data were similar between studies, data were pooled using frequency-weighted (FW) mean values to generate summary outcomes. Seven studies met the inclusion and exclusion criteria, and 133 patient cases were reviewed. FW mean age was 69.5 years. Patients were followed up an FW mean of 39.9 months. FW mean Constant score improved from 28.7 before surgery to 64.4 afterward (P = .0001). External rotation improved from an FW mean of -4° to 25° (P < .0001). The overall complication rate was 22.8%. RSA combined with latissimus dorsi tendon transfer can improve function and external rotation in patients with cuff tear arthropathy and teres minor dysfunction. Its overall complication rate appears to be similar to that of RSA alone, though the rate of neuropraxia may be increased.
在一项系统评价中，我们严格审查并综合了关于背阔肌肌腱转移的反肩关节置换术（RSA）的个体研究结果。检索了两个电子数据库。对于每项纳入研究，两名评价者评估其方法的质量并检索数据。在各研究之间结果数据相似的情况下，使用频率加权（FW）均值合并数据以生成汇总结果。七项研究符合纳入和排除标准，共审查了133例患者病例。FW平均年龄为69.5岁。患者的FW平均随访时间为39.9个月。FW平均Constant评分从术前的28.7提高到术后的64.4（P = .0001）。外旋从FW平均-4°提高到25°（P < .0001）。总体并发症发生率为22.8%。RSA联合背阔肌肌腱转移可改善肩袖撕裂性关节病和小圆肌功能障碍患者的功能和外旋。其总体并发症发生率似乎与单纯RSA相似，尽管神经失用症的发生率可能会增加。
