Suroto Heri, Anindita Satmoko Benedictus, Prajasari Tabita, De Vega Brigita, Wardhana Teddy Heri, Samijo Steven K
Department of Orthopedic and Traumatology, Faculty of Medicine, Universitas Airlangga/Dr. Soetomo General Academic Hospital, Surabaya, Indonesia.
Faculty of Medicine, Gadjah Mada University, Yogyakarta, Indonesia.
EFORT Open Rev. 2023 Oct 3;8(10):731-747. doi: 10.1530/EOR-23-0012.
The use of non-biodegradable suture anchors (NBSA) in arthroscopic rotator cuff repair (RCR) has increased significantly. However, several complications such as migration, chondral damage, revision, and imaging difficulties have been reported. Meanwhile, the effectiveness of biodegradable suture anchors (BSA) in overcoming such complications and achieving functional outcomes requires further study. Thus, we aim to compare the clinical outcomes and complications of RCR using BSA and NBSA using direct comparison studies.
Two independent reviewers conducted systematic searches in PubMed, Embase, Cochrane Library, and Web of Science from conception to September 2022. Using the RoB 2 and ROBINS-I tools, we assessed the included studies for bias. We applied GRADE to appraise our evidence. Our PROSPERO registration number is CRD42022354347.
Six studies (two randomized controlled trials, one retrospective cohort, and three case-control studies) involving 423 patients were included (211 patients received BSA and 212 patients received NBSA). BSA was comparable to NBSA in forward flexion, abduction, external rotation, Constant-Murley score, and perianchor cyst formation (P = 0.97, 0.81, 0.56, 0.29, and 0.56, respectively). Retear rates were slightly higher while tendon healing was reduced in BSA compared to NBSA, but the differences were not significant (P = 0.35 and 0.35, respectively).
BSA and NBSA appear to yield similar shoulder functions and complications in rotator cuff repairs.
在关节镜下肩袖修复术（RCR）中，不可生物降解缝线锚钉（NBSA）的使用显著增加。然而，已有多项并发症被报道，如移位、软骨损伤、翻修以及成像困难等。与此同时，可生物降解缝线锚钉（BSA）在克服此类并发症并实现功能预后方面的有效性仍需进一步研究。因此，我们旨在通过直接比较研究，对比使用BSA和NBSA进行RCR的临床疗效和并发症。
两名独立评审员从建库至2022年9月在PubMed、Embase、Cochrane图书馆和科学网进行了系统检索。我们使用RoB 2和ROBINS - I工具评估纳入研究的偏倚情况。我们应用GRADE对证据进行评估。我们的PROSPERO注册号为CRD42022354347。
纳入6项研究（2项随机对照试验、1项回顾性队列研究和3项病例对照研究），涉及423例患者（211例患者接受BSA，212例患者接受NBSA）。在向前屈曲、外展、外旋、Constant - Murley评分和锚钉周围囊肿形成方面，BSA与NBSA相当（P值分别为0.97、0.81、0.56、0.29和0.56）。与NBSA相比，BSA的再撕裂率略高，肌腱愈合率降低，但差异不显著（P值分别为0.35和0.35）。
在肩袖修复术中，BSA和NBSA似乎产生相似的肩部功能和并发症。
