Department of Orthopaedic Surgery, Arthroscopy and Sport Medicine, Hesperia Hospital, Arqua' Street, 41125 Modena, Italy.
Department of Biomedical and Speciality Surgical Sciences, Unit of Orthopaedic and Traumatology, S. Anna Hospital, Aldo Moro Street, 8, 41121 Ferrara, Italy.
Br Med Bull. 2020 Jul 9;134(1):85-96. doi: 10.1093/bmb/ldaa014.
The present systematic review compared arthroscopic superior capsular reconstruction (ASCR) and latissimus dorsi transfer (ALDT) for the management of massive irreparable rotator cuff lesions.
We performed a systematic review searching the literature on Medline, Cochrane and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
We included a total of 20 articles, 10 on ASCR and 10 on ALDT (12 retrospective and 8 prospective studies), all published between 2013 and 2019.
ASCR and ALDT are technical demanding procedures. When compared to each other, they do not produce significantly different improvements in clinical outcome.
Both ASCR and ALDT are valid options for surgical management of MIRCLs. Although ALDT has shown a greater complication rate and a less improvement in acromion-humeral distance, its clinical outcomes overlap those obtained with ASCR.
Further comparative prospective and retrospective studies with longer follow-up could confirm which surgical procedure can lead to better outcomes with a lower complication rate.
本系统评价比较了关节镜下肩袖上囊重建术（ASCR）和背阔肌转位术（ALDT）治疗巨大不可修复肩袖损伤的效果。
我们按照系统评价和荟萃分析的首选报告项目（PRISMA）指南，在 Medline、Cochrane 和 Scopus 数据库上进行了系统检索。
我们共纳入了 20 篇文章，其中 10 篇关于 ASCR，10 篇关于 ALDT（12 篇回顾性研究和 8 篇前瞻性研究），均发表于 2013 年至 2019 年。
ASCR 和 ALDT 都是技术要求很高的手术。与其他手术相比，它们在临床结果上并没有显著的改善。
ASCR 和 ALDT 都是治疗 MIRCL 的有效手术选择。虽然 ALDT 显示出更高的并发症发生率和更小的肩峰肱骨头距离改善，但它的临床结果与 ASCR 相似。
进一步进行比较前瞻性和回顾性研究，随访时间更长，可能有助于确定哪种手术方法可以获得更好的结果，同时并发症发生率更低。
