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年轻患者肩袖上盂唇前上部分(SLAP)撕裂的二头肌固定术与SLAP修复术的相似结果——一项荟萃分析

Similar outcomes between biceps tenodesis and SLAP repair for SLAP tears in younger patients - A meta-analysis.

作者信息

Hurley Eoghan T, Baker Rafeal, Danilkowicz Richard M, Levin Jay M, Klifto Christopher S, Dickens Jonathan F, Taylor Dean C, Lau Brian C

机构信息

Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, 27705, USA.

Department of Orthopedic Surgery, Duke University School of Medicine, Durham, NC, 27705, USA.

出版信息

J ISAKOS. 2024 Feb;9(1):79-83. doi: 10.1016/j.jisako.2023.09.007. Epub 2023 Oct 4.

Abstract

OBJECTIVES

The purpose of this study is to systematically review the comparative studies in the literature to ascertain if biceps tenodesis or superior-labrum anterior to posterior (SLAP) repair results in superior clinical outcomes in the treatment of type II SLAP tears in patients under 40.

METHODS

A systematic search of articles in Pubmed, EMBASE and The Cochrane Library databases was carried out according to the PRISMA guidelines. Cohort studies comparing biceps tenodesis to repair in type II SLAP tears in patients under 40 were included. Clinical outcomes were extracted including return to play, reoperations, ASES, and VAS for pain. All statistical analysis was performed using Review Manager. A p-value of <0.05 was considered to be statistically significant.

RESULTS

Five studies were included. Biceps tenodesis resulted in comparable rates of return to play compared to SLAP repair (78.5% vs 67.7%, p ​= ​0.33), and there was no significant difference in return to play in overhead athletes (83.6% vs 74%, p ​= ​0.82). There was no significant difference in ASES score (87.2 vs 86.2, p ​= ​0.27) or VAS score for pain (1.8 vs 2.1, p ​= ​0.48). There was no significant difference in re-operation rates (2.9% vs 10.8%, p ​= ​0.22).

CONCLUSION

This study found that biceps tenodesis has no significant difference in rates of return to play in athletes, as well as in functional outcome scores and rates of revision surgery in younger patients compared to SLAP repair.

LEVEL OF EVIDENCE

Level III, Systematic review of Level III studies.

摘要

目的

本研究旨在系统回顾文献中的比较研究,以确定二头肌固定术或上盂唇前后向(SLAP)修复术在治疗40岁以下患者的II型SLAP损伤时是否能带来更好的临床效果。

方法

根据PRISMA指南,对PubMed、EMBASE和Cochrane图书馆数据库中的文章进行系统检索。纳入比较40岁以下患者II型SLAP损伤的二头肌固定术与修复术的队列研究。提取临床结果,包括恢复运动、再次手术、ASES评分和疼痛视觉模拟评分(VAS)。所有统计分析均使用Review Manager进行。p值<0.05被认为具有统计学意义。

结果

纳入五项研究。与SLAP修复术相比,二头肌固定术的恢复运动率相当(78.5%对67.7%,p = 0.33), overhead运动员的恢复运动率无显著差异(83.6%对74%,p = 0.82)。ASES评分(87.2对86.2,p = 0.27)或疼痛VAS评分(1.8对2.1,p = 0.48)无显著差异。再次手术率无显著差异(2.9%对10.8%,p = 0.22)。

结论

本研究发现,与SLAP修复术相比,二头肌固定术在运动员的恢复运动率、年轻患者的功能结局评分和翻修手术率方面无显著差异。

证据水平

III级,III级研究的系统评价。

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