de Andrade André Luís Lugnani, Garcia Thiago Alves, Brandão Henrique de Sancti, Sardeli Amanda Veiga, Mouraria Guilherme Grisi, Belangero William Dias
Clinical Hospital, State University of Campinas, Campinas, São Paulo, Brazil.
Orthopaedic Biomaterials Laboratory (LABIMO), School of Medical Sciences, State University of Campinas, Campinas, São Paulo, Brazil.
Orthop J Sports Med. 2022 Mar 24;10(3):23259671211071146. doi: 10.1177/23259671211071146. eCollection 2022 Mar.
Despite technological advances, the overall retear rate on rotator cuff repair is still high. Patches have shown significant reduction in retear rate and pain scores; however, this is not a universal finding and conflicting results have been shown among functional shoulder scales.
To analyze previous controlled trials of the literature to bring a consensus about the effectiveness of patch use on rotator cuff repair.
Systematic review; Level of evidence, 1.
The search was conducted in PubMed, Web of Science, EMBASE, Scopus, and Cochrane in April 2020. The results of rotator cuff repair with patch augmentation versus without augmentation (control) were compared through odds ratio (OR), raw mean difference (RMD), and standardized mean difference (SMD) of retear rate; functional shoulder scales; strength; and range of motion (ROM).
Of 733 initial studies, 7 of them met the criteria to be included in the analysis. Compared with the control group, the patch augmentation group had a significantly lower retear rate (OR, 0.32 [95% CI, 0.18 to 0.55]; < .001), lower pain (SMD, -0.42 [-0.71 to -0.12]; < .01), a higher University of California Los Angeles Shoulder Rating Scale (RMD, 0.87 [0.15 to 1.60], = .017), and a trend toward higher strength (SMD, 0.95 [-0.03 to 1.94], = .05) and lower forward elevation ROM (RMD, -10.50 [-21.86 to 0.67]; = .06), while no changes were noted for other functional scales or for internal and external rotation ROM.
The results point to benefits of patch augmentation in rotator cuff repair, particularly a reduction in retear rate. More interventional studies with better methodological quality should be conducted to confirm the results of this initial review.
尽管技术不断进步，但肩袖修复术后的总体再撕裂率仍然很高。补片已显示出再撕裂率和疼痛评分显著降低；然而，这并非普遍现象，并且在功能性肩部量表中也出现了相互矛盾的结果。
分析先前文献中的对照试验，以就补片在肩袖修复中的有效性达成共识。
系统评价；证据等级，1级。
2020年4月在PubMed、科学网、EMBASE、Scopus和Cochrane进行检索。通过再撕裂率的比值比（OR）、原始均数差（RMD）和标准化均数差（SMD）；功能性肩部量表；力量；以及活动范围（ROM），比较使用补片增强与未增强（对照）的肩袖修复结果。
在733项初始研究中，有7项符合纳入分析的标准。与对照组相比，补片增强组的再撕裂率显著更低（OR，0.32 [95%CI，0.18至0.55]；P <.001），疼痛程度更低（SMD，-0.42 [-0.71至-0.12]；P <.01），加利福尼亚大学洛杉矶分校肩部评分量表得分更高（RMD，0.87 [0.15至1.60]，P =.017），并且力量有升高趋势（SMD，0.95 [-0.03至1.94]，P =.05），前屈活动范围更低（RMD，-10.50 [-21.86至0.67]；P =.06），而其他功能性量表或内旋和外旋活动范围未发现变化。
结果表明补片增强在肩袖修复中有益，尤其是再撕裂率降低。应开展更多方法学质量更好的干预性研究以证实这一初步综述的结果。
