Preuss Fletcher R, Eble Stephanie K, Peebles Annalise M, Osuna-Garcia Antonia, Provencher Capt Matthew T
David Geffen School of Medicine at The University of California Los Angeles, Los Angeles, CA, USA.
Geisel School of Medicine at Dartmouth College, Hanover, NH, USA.
JSES Rev Rep Tech. 2021 Dec 30;2(2):131-134. doi: 10.1016/j.xrrt.2021.11.004. eCollection 2022 May.
There is no differences in abduction, internal rotation, or external rotation strength after reverse total shoulder arthroplasty (rTSA) with or without subscapularis repair. Repair of the subscapularis can be effective in the setting of rTSA. However, consensus has yet to be reached on whether postoperative strength after rTSA differs based on subscapularis management. The purpose of this review is to evaluate shoulder strength outcomes after rTSA with and without subscapularis tendon repair.
A comprehensive literature review was conducted using the key terms "subscapularis" AND "reverse total shoulder arthroplasty" AND "muscle strength" in PubMed, Embase, Web of Science, Cochrane Reviews and Trials, and Scopus. Original, English-language studies evaluating shoulder strength outcomes after rTSA published from January 1, 2000, to present were evaluated. Strength outcomes reported included abduction strength (kg) and internal rotation strength (kg) using an electric spring balance and external rotation strength (lb) using a handheld dynamometer. Heterogeneity of data in the included studies did not allow for meta-analysis.
The search yielded 4253 unique results, which were screened for inclusion according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Two articles met eligibility criteria and were included in the final full-text review. A total of 267 shoulders were represented, 111 with subscapularis repair and 156 without subscapularis repair. No significant differences in abduction ( = .39), internal rotation ( = .09), and external rotation ( = .463) strength were observed between subscapularis repair and nonrepair groups.
There were no differences in abduction, internal rotation, or external rotation strength after rTSA with or without subscapularis repair. The literature on postoperative strength outcomes after rTSA is limited, and further study in this area is warranted.
在进行或不进行肩胛下肌修复的反式全肩关节置换术（rTSA）后，外展、内旋或外旋力量并无差异。肩胛下肌的修复在rTSA手术中可能有效。然而，对于rTSA术后力量是否因肩胛下肌处理方式不同而存在差异，尚未达成共识。本综述的目的是评估进行和未进行肩胛下肌腱修复的rTSA术后的肩部力量结果。
在PubMed、Embase、科学网、Cochrane综述与试验库以及Scopus数据库中，使用关键词“肩胛下肌”、“反式全肩关节置换术”和“肌肉力量”进行了全面的文献检索。对2000年1月1日至当前发表的评估rTSA术后肩部力量结果的英文原创研究进行了评估。报告的力量结果包括使用电子弹簧秤测量的外展力量（kg）和内旋力量（kg），以及使用手持测力计测量的外旋力量（lb）。纳入研究中的数据异质性不允许进行荟萃分析。
检索产生了4253条独特结果，根据系统评价和荟萃分析的首选报告项目（PRISMA）对其进行筛选以确定是否纳入。两篇文章符合纳入标准并被纳入最终的全文综述。共涉及267个肩部，其中111个进行了肩胛下肌修复，156个未进行肩胛下肌修复。在肩胛下肌修复组和未修复组之间，未观察到外展（P = 0.39）、内旋（P = 0.09）和外旋（P = 0.463）力量有显著差异。
在进行或不进行肩胛下肌修复的rTSA术后，外展、内旋或外旋力量并无差异。关于rTSA术后力量结果的文献有限，该领域有必要进一步研究。
