Hong Chih-Kai, Chang Chao-Jui, Kuan Fa-Chuan, Hsu Kai-Lan, Chen Yueh, Chiang Chen-Hao, Su Wei-Ren
Department of Orthopaedic Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan.
Orthop J Sports Med. 2020 Nov 5;8(11):2325967120961406. doi: 10.1177/2325967120961406. eCollection 2020 Nov.
Retear of a repaired rotator cuff tendon is a major issue for shoulder surgeons. It is possible that diabetes mellitus (DM) is associated with a greater risk of tendon retear after arthroscopic rotator cuff repair.
To determine whether patients with DM have a higher tendon retear risk after arthroscopic rotator cuff repair.
Systematic review; Level of evidence, 4.
A systematic review was conducted following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines using the Web of Science, PubMed, and Embase databases. Inclusion criteria were articles written in the English language that included patients undergoing arthroscopic rotator cuff repair surgeries, reported the numbers of patients with and those without DM, and reported the number of rotator cuff retears. Data relevant to this study were extracted and statistically analyzed. Random-effects models were used to generate pooled odds ratio estimates and CIs.
A total of 160 studies were identified from the initial search, and 5 of them met the inclusion criteria. A total of 1065 patients (207 patients with DM and 858 patients without DM) were included. The pooled results showed that the patients in the DM group had a significantly higher tendon retear risk than did those in the non-DM group (relative risk, 2.25; 95% CI, 1.14-4.45; = .02).
Patients with DM have a 2.25 times higher risk of tendon retear after arthroscopic rotator cuff repair compared with patients without DM.
修复后的肩袖肌腱再次撕裂是肩关节外科医生面临的一个主要问题。糖尿病（DM）可能与关节镜下肩袖修复术后肌腱再次撕裂的风险增加有关。
确定糖尿病患者在关节镜下肩袖修复术后是否有更高的肌腱再次撕裂风险。
系统评价；证据等级，4级。
按照PRISMA（系统评价和Meta分析的首选报告项目）指南，使用科学网、PubMed和Embase数据库进行系统评价。纳入标准为用英文撰写的文章，其中包括接受关节镜下肩袖修复手术的患者，报告有糖尿病和无糖尿病患者的数量，以及报告肩袖再次撕裂的数量。提取与本研究相关的数据并进行统计分析。采用随机效应模型生成合并比值比估计值和可信区间。
初步检索共识别出160项研究，其中5项符合纳入标准。共纳入1065例患者（207例糖尿病患者和858例非糖尿病患者）。汇总结果显示，糖尿病组患者的肌腱再次撕裂风险显著高于非糖尿病组（相对风险，2.25；95%可信区间，1.14 - 4.45；P = .02）。
与非糖尿病患者相比，糖尿病患者在关节镜下肩袖修复术后肌腱再次撕裂的风险高2.25倍。
