Alzahrani Wael M, Tashkandi Nada F, Faqeeh Mawddah H, Almatrafi Wijdan S, Amer Bugnah Abdulaziz A, Kazim Abdullah H
Department of Surgery, College of Medicine, Najran University, Najran, SAU.
College of Medicine, Almaarefa University, Riyadh, SAU.
Cureus. 2023 Jun 23;15(6):e40848. doi: 10.7759/cureus.40848. eCollection 2023 Jun.
This study aimed to evaluate the clinical outcomes and the frequency of return to sport after the arthroscopic repair of a humeral avulsion of the inferior glenohumeral ligament (HAGL) lesion. Web of Science, Scopus, and Medline via PubMed and OVID were searched to identify the relevant citations. Screening and data extraction were performed independently. The Comprehensive Meta-Analysis software was used for all statistical analyses (CMA; USA version 3.3.070). A total of 18 articles (n = 832 patients; of whom, 379 patients had HAGL) were included. The fixed-effect estimate showed that the percentage of patients who returned to their sports was 89.1% (95% CI = 85% to 92.2%). The mean duration to return was estimated to be 6.65 months (95% CI = 5.10 to 8.20). Postoperatively, the mean Western Ontario Shoulder Instability Index (WOSI), Oxford Shoulder Instability Score (OSIS), and Subjective Shoulder Value (SSV) scores were 88.60 (95% CI = 86.18 to 90.98), 15.02 (95% CI = 7.42 to 22.63), and 86.90 (95% CI = 80.79 to 93.00), respectively. The Rowe score improved significantly postoperatively with a mean difference (MD) of 54.47 (95% CI = 39.28 to 69.66). The University of California - Los Angeles (UCLA) shoulder score increased significantly post-arthroscopic repair (MD = 10.91, 95% CI = 10.07 to 11.76). The current evidence suggests that arthroscopic repair of HAGL lesions is associated with a high percentage of return to sports and improved Rowe score, WOSI, UCLA shoulder score, OSIS scale, and SSV score. The quality of the included studies is moderate; however, these findings are promising and call for further multicenter, prospective studies.
本研究旨在评估关节镜修复下盂肱韧带肱骨撕脱(HAGL)损伤后的临床疗效及恢复运动的频率。通过PubMed和OVID检索Web of Science、Scopus和Medline以识别相关文献。筛选和数据提取由独立人员进行。所有统计分析均使用综合Meta分析软件(CMA;美国版3.3.070)。共纳入18篇文章(n = 832例患者;其中379例患者为HAGL损伤)。固定效应估计显示恢复运动的患者百分比为89.1%(95%CI = 85%至92.2%)。恢复运动的平均时长估计为6.65个月(95%CI = 5.10至8.20)。术后,西部安大略肩不稳定指数(WOSI)、牛津肩不稳定评分(OSIS)和主观肩值(SSV)的平均分分别为88.60(95%CI = 86.18至90.98)、15.02(95%CI = 7.42至22.63)和86.90(95%CI = 80.79至93.00)。术后Rowe评分显著改善,平均差值(MD)为54.47(95%CI = 39.28至69.66)。关节镜修复术后加州大学洛杉矶分校(UCLA)肩评分显著提高(MD = 10.91,95%CI = 10.07至11.76)。目前的证据表明,关节镜修复HAGL损伤与较高的恢复运动百分比以及Rowe评分、WOSI、UCLA肩评分、OSIS量表和SSV评分的改善相关。纳入研究的质量中等;然而,这些发现很有前景,需要进一步开展多中心前瞻性研究。