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血脂异常与肩袖修复失败风险相关:一项系统评价和荟萃分析。

Dyslipidemia is associated with risk for rotator cuff repair failure: a systematic review and meta-analysis.

作者信息

Gatto Andrew P, Hu Daniel A, Feeley Brian T, Lansdown Drew

机构信息

College of Osteopathic Medicine, Touro University California, Vallejo, CA, USA.

Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

出版信息

JSES Rev Rep Tech. 2022 Mar 17;2(3):302-309. doi: 10.1016/j.xrrt.2022.02.003. eCollection 2022 Aug.

Abstract

BACKGROUND

Lipid deposition secondary to dyslipidemia (DLD) is shown to have a significant impact on tendon pathology, including tendon elasticity, fatty infiltration, and healing properties. Rotator cuff repair is a common procedure, susceptible to influence from many tear-related and patient-related characteristics. The purpose of this study was to determine the relationship between DLD and rotator cuff repair outcomes with analysis of retear risk and function.

METHODS

PubMed, Embase, and SPORTDiscus were searched for all English-language, peer-reviewed studies between 2000 and the present, which analyzed relationships between patient-related factors and outcomes of rotator cuff repair. Studies that explicitly examined the effect of DLD on rotator cuff repair outcomes were chosen for inclusion. Included studies were assessed for methodological quality, and data were extracted for meta-analysis.

RESULTS

Of the 3087 titles, 424 were screened by abstract, and 67 were reviewed in full. Inclusion criteria were met by 11 studies. Of these studies, 5 studies assessed retear, 2 studies measured function, 3 studies reported both retear and function, and 1 study evaluated the risk of retear necessitating a revision surgery. The studies report no significant difference in functional outcomes. Meta-analysis revealed that DLD patients had a significantly higher risk of retear after primary rotator cuff repair (odds ratio 1.32, 95% confidence interval 1.06-1.64).

CONCLUSION

DLD leads to an increased risk of retear after rotator cuff repair, although function appears to be unimpaired. DLD should be considered among other risk factors when counseling patients regarding expected rotator cuff repair outcomes.

摘要

背景

血脂异常(DLD)继发的脂质沉积对肌腱病理有显著影响,包括肌腱弹性、脂肪浸润和愈合特性。肩袖修复是一种常见手术,易受多种与撕裂相关及与患者相关特征的影响。本研究的目的是通过分析再撕裂风险和功能来确定DLD与肩袖修复结果之间的关系。

方法

检索PubMed、Embase和SPORTDiscus数据库,查找2000年至今所有英文的、经同行评审的研究,这些研究分析了患者相关因素与肩袖修复结果之间的关系。选择明确研究DLD对肩袖修复结果影响的研究纳入。对纳入研究进行方法学质量评估,并提取数据进行荟萃分析。

结果

在3087个标题中,通过摘要筛选出424篇,详细评审了67篇。11项研究符合纳入标准。在这些研究中,5项研究评估了再撕裂情况,2项研究测量了功能,3项研究同时报告了再撕裂和功能情况,1项研究评估了需要翻修手术的再撕裂风险。这些研究报告功能结果无显著差异。荟萃分析显示,DLD患者在初次肩袖修复后再撕裂风险显著更高(优势比1.32,95%置信区间1.06 - 1.64)。

结论

DLD导致肩袖修复后再撕裂风险增加,尽管功能似乎未受损害。在向患者咨询肩袖修复预期结果时,应将DLD与其他风险因素一并考虑。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/974c/10426695/5a1f7d25f71d/gr1.jpg

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