Pan Am Clinic, Winnipeg, Manitoba, Canada; Department of Orthopaedic Surgery, University of Manitoba, Winnipeg, Manitoba, Canada.
Department of Orthopaedic Surgery, Emory University, Atlanta, Georgia, U.S.A.
Arthroscopy. 2021 Sep;37(9):2960-2972. doi: 10.1016/j.arthro.2021.03.076. Epub 2021 Apr 20.
The purpose of this systematic review is to characterize the complications associated with superior capsule reconstruction (SCR) for the treatment of functionally irreparable rotator cuff tears (FIRCTs).
This systematic review was completed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Two independent reviewers completed a search of PubMed, Embase, and Medline databases. Studies were deemed eligible for inclusion if they reported postoperative outcomes of arthroscopic SCR for FIRCTs and considered at least 1 postoperative complication. Statistical heterogeneity was quantified via the I statistic. Due to marked heterogeneity, pooled proportions were not reported. All complications and patient-reported outcomes were described qualitatively.
Fourteen studies met the inclusion/exclusion criteria. The overall complication rate post-SCR ranged from 5.0% to 70.0% (I = 84.9%). Image-verified graft retear ranged from 8% to 70%, I = 79.4%), with higher rates reported when SCR was performed using allograft (19%-70%, I 76.6%) compared to autograft (8%-29%, I = 66.1%). Reoperation (0%-36%, I = 73.4%), revision surgeries (0%-21%, I = 81.2%), medical complications (0%-5%, I = 0.0%), and infections (0%-5%, I = 0.0%) were also calculated.
SCR carries a distinct complication profile when used for the treatment of FIRCTs. The overall rate of complications ranged from 5.0% to 70.0%. The most common complication is graft retear with higher ranges in allografts (19%-70%) compared to autografts (8%-29%). The majority of studies reported at least 1 reoperation (range, 0%-36%), most commonly for revision to reverse shoulder arthroplasty.
Level IV, systematic review of Level IV or better investigations.
本系统评价的目的是描述与治疗功能不可修复肩袖撕裂（FIRCT）相关的上囊重建（SCR）的并发症特征。
本系统评价是按照系统评价和荟萃分析的首选报告项目完成的。两名独立的审查员对 PubMed、Embase 和 Medline 数据库进行了搜索。如果研究报告了 FIRCT 关节镜 SCR 的术后结果，并考虑了至少 1 种术后并发症，则认为其符合纳入标准。通过 I 统计量量化了统计异质性。由于存在显著的异质性，因此未报告汇总比例。所有并发症和患者报告的结果均进行定性描述。
14 项研究符合纳入/排除标准。SCR 后总体并发症发生率为 5.0%至 70.0%（I = 84.9%）。影像学证实的移植物再撕裂率为 8%至 70%，I = 79.4%，当 SCR 使用同种异体移植物（19%至 70%，I = 76.6%）时报告的发生率高于自体移植物（8%至 29%，I = 66.1%）。再次手术（0%至 36%，I = 73.4%）、翻修手术（0%至 21%，I = 81.2%）、医疗并发症（0%至 5%，I = 0.0%）和感染（0%至 5%，I = 0.0%）也进行了计算。
SCR 用于治疗 FIRCT 时具有独特的并发症特征。并发症的总体发生率为 5.0%至 70.0%。最常见的并发症是移植物再撕裂，同种异体移植物（19%至 70%）的发生率高于自体移植物（8%至 29%）。大多数研究报告至少 1 次再手术（范围，0%至 36%），最常见的是翻修为反向肩关节置换术。
IV 级，对 IV 级或更高级别的研究进行系统评价。
