Stamiris Dimitrios, Stamiris Stavros, Papavasiliou Kyriakos, Potoupnis Michail, Tsiridis Eleftherios, Sarris Ioannis
Academic Orthopedic Department, Aristotle University of Thessaloniki Medical School, Thessaloniki; CORE - Center of Orthopedic Research, Center for Interdisciplinary Research and Innovation, Thessaloniki, Greece.
Orthop Rev (Pavia). 2020 Apr 28;12(1):8457. doi: 10.4081/or.2020.8457. eCollection 2020 Apr 22.
Aim of this study was to investigate the potential influence of Critical Shoulder Angle (CSA) as a predisposing factor for the development of degenerative full-thickness rotator cuff tears (DRCT) or primary glenohumeral osteoarthritis (PGOA). A systematic review of the Pubmed, Scopus, Mendeley, ScienceDirect and the Cochrane Central Register of Controlled Trials online databases was performed for literature regarding CSA and its association with DRCT and PGOA. In order to evaluate solely the relationship between CSA as a predisposing factor for the development of the aforementioned degenerative shoulder diseases (DSDs), we precluded any study in which traumatic cases were not clearly excluded. Our search strategy identified 289 studies in total, nine of which were eligible for inclusion based on our pre-established criteria. Quality assessment contacted using the Newcastle Ottawa Scale for case-control studies. There were a total of 998 patients with DRCT and 285 patients with PGOA. The control groups consisted of a total of 538 patients. The mean CSA ranged from 33.9° to 41.01° for the DRCT group, from 27.3° to 29.8° for the PGOA group and from 30.2° to 37.28° for the control group. All studies reported statistically significant differences between the DRCT and PGOA groups and the respective control groups. Our study results showed that there is moderate evidence in the literature supporting an intrinsic role of CSA in the development of DSDs. Level of evidence: IV. Systematic review of diagnostic studies, Level II-IV.
本研究的目的是调查临界肩角（CSA）作为退行性全层肩袖撕裂（DRCT）或原发性盂肱关节骨关节炎（PGOA）发展的易感因素的潜在影响。对PubMed、Scopus、Mendeley、ScienceDirect和Cochrane对照试验中央注册库在线数据库进行了系统回顾，以查找有关CSA及其与DRCT和PGOA关联的文献。为了仅评估CSA作为上述退行性肩部疾病（DSD）发展的易感因素之间的关系，我们排除了任何未明确排除创伤性病例的研究。我们的检索策略共识别出289项研究，其中9项根据我们预先设定的标准符合纳入条件。使用纽卡斯尔渥太华量表对病例对照研究进行质量评估。共有998例DRCT患者和285例PGOA患者。对照组共有538例患者。DRCT组的平均CSA范围为33.9°至41.01°，PGOA组为27.3°至29.8°，对照组为30.2°至37.28°。所有研究均报告DRCT组和PGOA组与各自对照组之间存在统计学显著差异。我们的研究结果表明，文献中有中等证据支持CSA在DSD发展中具有内在作用。证据级别：IV。诊断研究的系统评价，II-IV级。
