Weick Jack W, Workman Will B, Bush Christopher J, McCollum Katherine A, Sugaya Hiroyuki, Freehill Michael T
Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, U.S.A.
Walnut Creek Orthopedics & Sports Medicine, Team Orthopedic Surgeon, Oakland Athletics, Walnut Creek, California.
Arthrosc Sports Med Rehabil. 2021 Feb 23;3(2):e289-e296. doi: 10.1016/j.asmr.2020.09.003. eCollection 2021 Apr.
To systematically review the available literature to further describe and report the available data on SLAP repair techniques and the association with outcomes.
A systematic review of literature was performed on manuscripts describing type II SLAP repairs in athletes. Selection criteria included studies reporting exclusively type II SLAP tears without concomitant pathology, minimum 2-year postoperative follow-up, use of anchor fixation, and return to previous level of play data available. We extracted patient outcome as well as surgical construct details from each article. Average outcomes and return to play rates were calculated and substratified further by athlete type. Return to play rates were compared by repair constructs with the Student test.
Initial search resulted in 107 articles. After exclusion criteria were applied, 17 articles were included in the final analysis. Overall, 84% of patients had good-to-excellent results. Of all athletes, 66% returned to previous level of play. There was significant variation in reported technique in terms of anchor number, location, material, suture type, and knotless versus knotted constructs. No significant difference was reported in outcomes in comparison of suture type (-value .96) or knotted versus knotless constructs (-value .91). Given the significant variability in reporting, no statistical analysis was felt able to be performed on anchor location and number.
Repair of type II SLAP tears in athletes is a difficult problem to treat with overall low return to play despite a high rate of "good" outcomes when assessed by outcome measures. Significant variability exists in surgical technique, as well as reporting of surgical technique, potentially limiting the ability to define the best or most effective technique for SLAP repair.
IV, systematic review of level III and level IV studies.
系统回顾现有文献，以进一步描述和报告关于肩盂唇上盂唇从前到后（SLAP）损伤修复技术的可用数据及其与治疗结果的关联。
对描述运动员II型SLAP损伤修复的手稿进行文献系统回顾。选择标准包括仅报告不伴有其他病变的II型SLAP撕裂的研究、术后至少2年的随访、使用锚钉固定以及有恢复到先前运动水平的数据。我们从每篇文章中提取患者的治疗结果以及手术结构细节。计算平均治疗结果和恢复运动率，并按运动员类型进一步分层。使用学生t检验比较不同修复结构的恢复运动率。
初步检索得到107篇文章。应用排除标准后，最终分析纳入17篇文章。总体而言，84%的患者取得了良好至优异的治疗结果。在所有运动员中，66%恢复到了先前的运动水平。在报告的技术方面，锚钉数量、位置、材料、缝线类型以及无结与有结结构存在显著差异。在比较缝线类型（p值 = 0.96）或有结与无结结构（p值 = 0.91）时，报告的治疗结果无显著差异。鉴于报告存在显著变异性，认为无法对锚钉位置和数量进行统计分析。
运动员II型SLAP撕裂的修复是一个难以治疗的问题，尽管通过治疗结果评估有较高的“良好”治疗结果率，但恢复运动的总体比例较低。手术技术以及手术技术的报告存在显著变异性，这可能限制了确定最佳或最有效SLAP修复技术的能力。
IV，III级和IV级研究的系统回顾。
