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关节镜下全层肩袖撕裂修复术中肩峰成形术的系统评价和Meta分析

Systematic review and Meta-analysis on acromioplasty in arthroscopic repair of full-thickness rotator cuff tears.

作者信息

Sun Zhengyu, Fu Weili, Tang Xin, Chen Gang, Li Jian

出版信息

Acta Orthop Belg. 2018 Mar;84(1):54-61.

Abstract

The purpose of this study was to perform a systematic review and meta-analysis including all available randomized controlled trials to determine the role of acromioplasty in arthroscopic repair of full-thickness rotator cuff tears. A literature search was conducted in PubMed, Embase, Cochrane, and Web of Science. All randomized and quasi-randomized controlled trials evaluating the outcomes of arthroscopic repair of full-thickness rotator cuff tears with or without acromioplasty were included in our meta-analysis. After the studies were selected by two reviewers, data were collected and extracted independently. Data were pooled for American Shoulder and Elbow Surgeons (ASES) score, Constant-Murley (CM) score, University of California-Los Angeles (UCLA) score, visual analog scale (VAS) for pain and reoperation rate. Five prospective randomized studies involving 465 patients were included. The current meta-analysis did not show any significant difference between acromioplasty and nonacromioplasty groups with regard to the outcomes for ASES score, CM score, UCLA score (P = .17, .05, and .13, respectively). There was also no significant difference in VAS for pain and reoperation rate between the two groups (P = .87, and .57, respectively). On the basis of the currently available evidence, there was no statistically significant difference in clinical outcomes for patients undergoing arthroscopic rotator cuff repair with or without acromioplasty at short-term follow-up.

摘要

本研究的目的是进行一项系统评价和荟萃分析,纳入所有可用的随机对照试验,以确定肩峰成形术在关节镜修复全层肩袖撕裂中的作用。在PubMed、Embase、Cochrane和科学网进行了文献检索。我们的荟萃分析纳入了所有评估全层肩袖撕裂关节镜修复(无论是否行肩峰成形术)结局的随机和半随机对照试验。由两名 reviewers 选择研究后,独立收集和提取数据。汇总美国肩肘外科医师学会(ASES)评分、Constant-Murley(CM)评分、加州大学洛杉矶分校(UCLA)评分、疼痛视觉模拟量表(VAS)和再次手术率的数据。纳入了五项涉及465例患者的前瞻性随机研究。目前的荟萃分析显示,在ASES评分、CM评分、UCLA评分的结局方面,肩峰成形术组和非肩峰成形术组之间没有显著差异(P值分别为0.17、0.05和0.13)。两组之间的疼痛VAS和再次手术率也没有显著差异(P值分别为0.87和0.57)。基于目前可得的证据,在短期随访中,接受关节镜肩袖修复(无论是否行肩峰成形术)的患者临床结局没有统计学上的显著差异。

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