Imam Nareena, Sudah Suleiman Y, Manzi Joseph E, Michel Christopher R, Pizzo Dane M, Menendez Mariano E, Nicholson Allen D
Robert Wood Johnson Medical School, New Brunswick Chicago, Illinois, U.S.A.
Department of Orthopedic Surgery, Monmouth Medical Center, Long Branch Chicago, Illinois, U.S.A.
Arthrosc Sports Med Rehabil. 2023 Jan 2;5(1):e281-e295. doi: 10.1016/j.asmr.2022.11.016. eCollection 2023 Feb.
The purpose of this review was to systematically evaluate the literature on pediatric shoulder arthroscopy and outline its indications, outcomes, and complications.
This systematic review was carried out in accordance with PRISMA guidelines. PubMed, Cochrane Library, ScienceDirect, and OVID Medline were searched for studies reporting the indications, outcomes, or complications in patients undergoing shoulder arthroscopy under the age of 18 years. Reviews, case reports, and letters to the editor were excluded. Data extracted included surgical techniques, indications, preoperative and postoperative functional and radiographic outcomes, and complications. The methodological quality of included studies was evaluated using the Methodological Index for Non-Randomized Studies (MINORS) tool.
Eighteen studies, with a mean MINORS score of 11.4/16, were identified, including a total of 761 shoulders (754 patients). Weighted average age was 13.6 years (range, 0.83-18.8 years) with a mean follow-up time of 34.6 months (range, 6-115). As part of their inclusion criteria, 6 studies (230 patients) recruited patients with anterior shoulder instability and 3 studies recruited patients with posterior shoulder instability (80 patients). Other indications for shoulder arthroscopy included obstetric brachial plexus palsy (157 patients) and rotator cuff tears (30 patients). Studies reported a significant improvement in functional outcomes for arthroscopy indicated for shoulder instability and obstetric brachial plexus palsy. A significant improvement was also noted in radiographic outcomes and range of motion for obstetric brachial plexus palsy patients. The overall rate of complication ranged from 0% to 25%, with 2 studies reporting no complications. The most common complication was recurrent instability (38 patients of 228 [16.7%]). Fourteen of the 38 patients (36.8%) underwent reoperation.
Among pediatric patients, shoulder arthroscopy was indicated most commonly for instability, followed by brachial plexus birth palsy, and partial rotator cuff tears. Its use resulted in good clinical and radiographic outcomes with limited complications.
Systematic review of Level II to IV studies.
本综述的目的是系统评价有关儿童肩关节镜检查的文献，并概述其适应证、治疗效果及并发症。
本系统综述按照PRISMA指南进行。检索了PubMed、Cochrane图书馆、ScienceDirect和OVID Medline，以查找报告18岁以下接受肩关节镜检查患者的适应证、治疗效果或并发症的研究。排除综述、病例报告和致编辑的信。提取的数据包括手术技术、适应证、术前和术后功能及影像学结果以及并发症。使用非随机研究方法学指数（MINORS）工具评估纳入研究的方法学质量。
共纳入18项研究，MINORS评分平均为11.4/16，共涉及761个肩关节（754例患者）。加权平均年龄为13.6岁（范围0.83 - 18.8岁），平均随访时间为34.6个月（范围6 - 115个月）。作为纳入标准的一部分，6项研究（230例患者）纳入了肩前不稳定患者，3项研究纳入了肩后不稳定患者（80例患者）。肩关节镜检查的其他适应证包括产瘫（157例患者）和肩袖撕裂（30例患者）。研究报告称，针对肩关节不稳定和产瘫进行的关节镜检查在功能结局方面有显著改善。产瘫患者的影像学结果和活动范围也有显著改善。总体并发症发生率为0%至25%，2项研究报告无并发症。最常见的并发症是复发性不稳定（228例中有38例患者[16.7%]）。38例患者中有14例（36.8%）接受了再次手术。
在儿童患者中，肩关节镜检查最常见的适应证是不稳定，其次是臂丛神经产瘫和部分肩袖撕裂。其应用产生了良好的临床和影像学结果，并发症有限。
II至IV级研究的系统综述
