Department of Orthopaedic Surgery, Division of Sports Medicine, Rush University Medical Center, Chicago, Illinois, U.S.A.
Department of Orthopaedic Surgery, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Arthroscopy. 2020 Jun;36(6):1738-1746. doi: 10.1016/j.arthro.2020.01.052. Epub 2020 Feb 11.
To compare knotted and knotless transosseous equivalent (TOE) rotator cuff repair (RCR) techniques and evaluate their imaging-diagnosed retear rates.
The Cochrane Database of Systematic Reviews, the Cochrane Central Register of Controlled Trials, PubMed (2008 to 2019), EMBASE (2008 to 2019), and Medline (2008 to 2019) were used to perform a systematic review and meta-analysis using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) criteria, with the following search terms: rotator cuff repair AND (knotless OR knotted) AND transosseous; rotator cuff repair AND (knotless OR knotted or transosseous); rotator cuff repair AND ("suture bridge" OR "suture bridging"). Data pertaining to demographic characteristics, surgical techniques, retears, and patient-reported outcomes were extracted from each study. Rates and locations of retear were reported using ranges, and risks of bias and heterogeneity for each study were assessed.
A total of 7 studies (552 shoulders) were included. Patients had a weighted mean (± standard deviation) age of 60.5 ± 2.4 years with 27.8 ± 7.9-month follow-up. The incidence of retears ranged from 5.1% to 33.3% in patients treated with knotless TOE RCR, and the incidence for patients treated with knotted TOE RCR ranged from 7.5% to 25%. The incidence of type I retears ranged from 42.9% to 100% for patients treated with knotless TOE RCR and 20% to 100% for patients treated with knotted TOE RCR. The incidence of type II retears ranged from 0% to 57.1% in patients treated with knotless TOE RCR and 0% to 100% in patients treated with knotted TOE RCR.
The incidence and location of retears after knotless and knotted TOE RCR appear to be similar.
比较带线锚钉与无结线锚钉经骨隧道固定技术修复肩袖撕裂（RCR）的效果，并评估其影像学诊断的再撕裂率。
采用 PRISMA（系统评价和荟萃分析首选报告项目）标准，通过 Cochrane 系统评价数据库、Cochrane 对照试验中心注册库、PubMed（2008 年至 2019 年）、EMBASE（2008 年至 2019 年）和 Medline（2008 年至 2019 年）进行系统评价和荟萃分析，检索词包括：rotator cuff repair 和（knotless 或 knotted）和 transosseous；rotator cuff repair 和（knotless 或 knotted 或 transosseous）；rotator cuff repair 和（"suture bridge" 或 "suture bridging"）。从每项研究中提取与人口统计学特征、手术技术、再撕裂和患者报告结果相关的数据。使用范围报告再撕裂的发生率和位置，评估每项研究的偏倚风险和异质性。
共纳入 7 项研究（552 例肩关节）。患者的加权平均（±标准差）年龄为 60.5±2.4 岁，随访时间为 27.8±7.9 个月。无结线锚钉经骨隧道固定 RCR 组患者的再撕裂发生率为 5.1%至 33.3%，带线锚钉经骨隧道固定 RCR 组患者的再撕裂发生率为 7.5%至 25%。无结线锚钉经骨隧道固定 RCR 组患者的 I 型再撕裂发生率为 42.9%至 100%，带线锚钉经骨隧道固定 RCR 组患者的 I 型再撕裂发生率为 20%至 100%。无结线锚钉经骨隧道固定 RCR 组患者的 II 型再撕裂发生率为 0%至 57.1%，带线锚钉经骨隧道固定 RCR 组患者的 II 型再撕裂发生率为 0%至 100%。
无结线锚钉与带线锚钉经骨隧道固定 RCR 后的再撕裂发生率和位置似乎相似。
