Zhao Jinlong, Luo Minghui, Pan Jianke, Liang Guihong, Feng Wenxuan, Zeng Lingfeng, Yang Weiyi, Liu Jun
The Second School of Clinical Medical Sciences, Guangzhou University of Chinese Medicine, Guangzhou, China; Research Team on Bone and Joint Degeneration and Injury, Guangdong Academy of Traditional Chinese Medicine, Guangzhou, China.
Research Team on Bone and Joint Degeneration and Injury, Guangdong Academy of Traditional Chinese Medicine, Guangzhou, China; The Second Affiliated Hospital, Guangzhou University of Chinese Medicine (Guangdong Province Hospital of Traditional Chinese Medicine), Guangzhou, China.
J Shoulder Elbow Surg. 2021 Nov;30(11):2660-2670. doi: 10.1016/j.jse.2021.05.010. Epub 2021 Jun 2.
Retear after arthroscopic rotator cuff repair (ARCR) consistently challenges medical staff and patients, and the incidence of retear after surgery is 10%-94%. The purpose of this study was to identify the risk factors that cause retear after ARCR and provide theoretical guidance for clinical intervention to reduce the occurrence of postoperative rotator cuff retear.
The protocol for this meta-analysis was registered with PROSPERO (CRD42021225088). PubMed, Web of Science, and Embase were searched for observational studies on risk factors for rotator cuff retear after arthroscopic repair. Meta-analytical methods were used to determine the odds ratio or weighted mean difference of potential risk factors related to postoperative rotator cuff retear. Stata 15.1 was used to quantitatively evaluate the publication bias of the statistical results.
Fourteen studies from 6 countries with a total of 5693 patients were included. The meta-analysis revealed that the risk factors for retear after rotator cuff repair were age, body mass index, diabetes, subscapularis and infraspinatus fatty infiltration, symptom duration, bone mineral density, tear length, tear width, tear size area, amount of retraction, critical shoulder angle, acromiohumeral interval, distance from the musculotendinous junction to the glenoid, operative duration, biceps procedure, and postoperative University of California Los Angeles shoulder score.
These findings can help clinical medical staff identify patients who are prone to retear early after arthroscopic repair and develop targeted prevention and treatment strategies for modifiable risk factors, which are of great significance for reducing the occurrence of rotator cuff retear after ARCR.
关节镜下肩袖修复术(ARCR)后再撕裂一直是医护人员和患者面临的挑战,术后再撕裂的发生率为10%-94%。本研究的目的是确定ARCR后导致再撕裂的危险因素,并为临床干预提供理论指导,以减少术后肩袖再撕裂的发生。
本荟萃分析方案已在PROSPERO(CRD42021225088)注册。检索了PubMed、Web of Science和Embase上关于关节镜修复后肩袖再撕裂危险因素的观察性研究。采用荟萃分析方法确定与术后肩袖再撕裂相关的潜在危险因素的比值比或加权平均差。使用Stata 15.1对统计结果的发表偏倚进行定量评估。
纳入了来自6个国家的14项研究,共5693例患者。荟萃分析显示,肩袖修复术后再撕裂的危险因素包括年龄、体重指数、糖尿病、肩胛下肌和冈下肌脂肪浸润、症状持续时间、骨密度、撕裂长度、撕裂宽度、撕裂面积、回缩量、临界肩角、肩峰下间隙、肌腱-肌肉交界处至关节盂的距离、手术时间、肱二头肌手术以及术后加州大学洛杉矶分校肩评分。
这些发现有助于临床医护人员早期识别关节镜修复后容易发生再撕裂的患者,并针对可改变的危险因素制定有针对性的预防和治疗策略,这对于减少ARCR后肩袖再撕裂的发生具有重要意义。