年龄对肩袖修复术后再撕裂风险的影响：一项系统综述和荟萃分析。
The effect of age on risk of retear after rotator cuff repair: a systematic review and meta-analysis.
作者信息
Khazzam Michael, Sager Brian, Box Hayden N, Wallace Steven B
机构信息
Shoulder Service, Department of Orthopaedic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
出版信息
JSES Int. 2020 Jun 10;4(3):625-631. doi: 10.1016/j.jseint.2020.03.014. eCollection 2020 Sep.
HYPOTHESIS
The purpose of this study was to perform a systematic review and meta-analysis to determine the effect of age on rotator cuff repair failure. The hypothesis of this study was that increased patient age would lead to a higher rate of retears and/or repair failures after rotator cuff repair.
METHODS
We conducted a systematic review and meta-analysis of level I and II studies evaluating patients undergoing rotator cuff repair that also included an imaging assessment of the structural integrity of the repair. Univariate and multivariate meta-regression was performed to assess the dependence of the retear rate on the mean age of the cohort, imaging modality, time to imaging, and publication year.
RESULTS
The meta-regression included 38 studies with a total of 3072 patients. Significant heterogeneity in retear rates was found among the studies ( = 209.53, = 82.34, < .001). By use of a random-effects model, the retear rate point estimate was 22.1% (95% confidence interval [CI], 18.6%-26.0%). On univariate analysis, type of imaging modality did not significantly influence the retear rate ( = .188). On univariate analysis, mean age (odds ratio [OR], 1.05 [95% CI, 1.01-1.09]; = .027) and mean time to imaging (OR, 1.04 [95% CI, 1.01-1.08]; = .006) were associated with the retear rate. Publication year (OR, 0.94 [95% CI, 0.88-1.01]; = .083) demonstrated a trend toward significance. On multivariate analysis, increased age was associated with a 5%/yr increased odds of retear (OR, 1.05 [95% CI, 1.01-1.08]; = .025). The risk of retear doubled from 15% at age 50 years to >30% at age 70 years. Time to imaging demonstrated a trend toward increased odds of retear (OR, 1.03 [95% CI, 1.00-1.07]; = .056). Publication year was not associated with the retear rate on multivariate analysis (OR, 0.96 [95% CI, 0.90-1.02]; = .195).
CONCLUSION
The risk of retear after rotator cuff repair is associated with increased age and doubles between the ages of 50 and 70 years.
假设
本研究的目的是进行一项系统评价和荟萃分析，以确定年龄对肩袖修复失败的影响。本研究的假设是，患者年龄增加会导致肩袖修复术后再撕裂和/或修复失败的发生率更高。
方法
我们对评估肩袖修复患者的I级和II级研究进行了系统评价和荟萃分析，这些研究还包括对修复结构完整性的影像学评估。进行单变量和多变量meta回归，以评估再撕裂率对队列平均年龄、成像方式、成像时间和发表年份的依赖性。
结果
meta回归纳入了38项研究，共3072例患者。研究间再撕裂率存在显著异质性（I² = 209.53，P <.001）。采用随机效应模型，再撕裂率点估计值为22.1%（95%置信区间[CI]，18.6%-26.0%）。单变量分析中，成像方式类型对再撕裂率无显著影响（P =.188）。单变量分析中，平均年龄（优势比[OR]，1.05[95%CI，1.01-1.09]；P =.027）和平均成像时间（OR，1.04[95%CI，1.01-1.08]；P =.006）与再撕裂率相关。发表年份（OR，0.94[95%CI，0.88-1.01]；P =.083）显示出有显著意义的趋势。多变量分析中，年龄增加与每年再撕裂几率增加5%相关（OR，1.05[95%CI，1.01-1.08]；P =.025）。再撕裂风险从50岁时的15%增加一倍，至70岁时>30%。成像时间显示再撕裂几率有增加趋势（OR，1.03[95%CI，1.00-1.07]；P =.056）。多变量分析中，发表年份与再撕裂率无关（OR，0.96[95%CI，0.90-1.02]；P =.195）。
结论
肩袖修复术后再撕裂风险与年龄增加相关，且在50至70岁之间翻倍。
Zotero 插件