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临床诊断肩胛下肌不完全撕裂的方法:一项荟萃分析。

Clinical Approach to Inconclusive Subscapularis Tear Diagnosis: a Meta-analysis.

机构信息

Orthopedics, Peking University First Hospital, Beijing, China.

Orthopedics, Peking University Third Hospital, Beijing, China.

出版信息

Int J Sports Med. 2024 Feb;45(2):85-94. doi: 10.1055/a-2158-8278. Epub 2023 Oct 11.


DOI:10.1055/a-2158-8278
PMID:37820692
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10834114/
Abstract

To identify factors associated with subscapularis (SSC) tears and provide a theoretical basis for clinical diagnosis, we included studies related to subscapularis tears published before February 1, 2023. We screened for six predictors across previous studies for the meta-analysis. The predictors included age, sex, coracoid overlap (CO), coracohumeral distance (CHD), impairment of the long head of the biceps tendon (LHB), and dominant arm. The Newcastle-Ottawa Scale (NOS) was used to evaluate the quality of the studies. The risk ratios (RRs) and the weighted mean differences (WMDs) were used to evaluate the effect size of categorical variables and continuous variables, respectively. The Egger test was used to assess the publication bias of the studies. Ten studies were included from seven countries. A total of 2 126 patients were enrolled, of whom 1 041 had subscapularis tears and 1 085 did not. The study showed that age (WMD, 4.23 [95% CI, 2.32-6.15]; P<.00001), coracoid overlap (WMD, 1.98 [95% CI, 1.55-2.41]; P<.00001), coracohumeral distance(WMD, -1.03 [95% CI, -1.17- -0.88]; P<.00001), and an injury of the long head of the biceps tendon (RR, 4.98 [95% CI, 3.75-6.61]; P<.00001) were risk factors for subscapularis tears. These risk factors can help clinicians identify subscapularis tears early and select appropriate interventions. The level of evidence is 3.

摘要

为了确定与肩胛下肌撕裂相关的因素,并为临床诊断提供理论依据,我们纳入了截至 2023 年 2 月 1 日之前发表的与肩胛下肌撕裂相关的研究。我们对纳入的研究进行了分析,共筛选出 6 个预测因子,包括年龄、性别、喙突重叠(CO)、肩肱距离(CHD)、肱二头肌长头肌腱损伤(LHB)和优势臂。我们使用纽卡斯尔-渥太华量表(NOS)评估研究质量。风险比(RR)和加权均数差(WMD)分别用于评估分类变量和连续变量的效应大小。Egger 检验用于评估研究的发表偏倚。我们从 7 个国家的 10 项研究中纳入了 2126 名患者,其中 1041 名患者有肩胛下肌撕裂,1085 名患者没有。研究表明,年龄(WMD,4.23 [95%CI,2.32-6.15];P<.00001)、喙突重叠(WMD,1.98 [95%CI,1.55-2.41];P<.00001)、肩肱距离(WMD,-1.03 [95%CI,-1.17- -0.88];P<.00001)和肱二头肌长头肌腱损伤(RR,4.98 [95%CI,3.75-6.61];P<.00001)是肩胛下肌撕裂的危险因素。这些危险因素可以帮助临床医生早期识别肩胛下肌撕裂,并选择合适的干预措施。证据水平为 3 级。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/34ee3a1cf892/10-1055-a-2158-8278-i9987-0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/68c41a031890/10-1055-a-2158-8278-i9987-0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/ac97dba8873e/10-1055-a-2158-8278-i9987-0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/620fa8dc8ab4/10-1055-a-2158-8278-i9987-0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/6d875deb2dbc/10-1055-a-2158-8278-i9987-0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/b30d1f2a4495/10-1055-a-2158-8278-i9987-0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/5d4bbff05d72/10-1055-a-2158-8278-i9987-0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/adba9d383448/10-1055-a-2158-8278-i9987-0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/34ee3a1cf892/10-1055-a-2158-8278-i9987-0008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/68c41a031890/10-1055-a-2158-8278-i9987-0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/ac97dba8873e/10-1055-a-2158-8278-i9987-0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/620fa8dc8ab4/10-1055-a-2158-8278-i9987-0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/6d875deb2dbc/10-1055-a-2158-8278-i9987-0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/b30d1f2a4495/10-1055-a-2158-8278-i9987-0005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/5d4bbff05d72/10-1055-a-2158-8278-i9987-0006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/adba9d383448/10-1055-a-2158-8278-i9987-0007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/edd5/10834114/34ee3a1cf892/10-1055-a-2158-8278-i9987-0008.jpg

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引用本文的文献

[1]
Which radiological parameters of the coracoid process influence the diagnosis of atraumatic subscapularis tears? Systematic review and meta-analysis.

Eur J Orthop Surg Traumatol. 2025-9-6

本文引用的文献

[1]
Identifying key factors associated with subscapularis tendon tears and developing a risk prediction model to assist diagnosis.

BMC Musculoskelet Disord. 2022-4-27

[2]
Evaluation of subscapularis tendon tears of the anterosuperior aspect using radial-sequence magnetic resonance imaging.

JSES Int. 2021-9-28

[3]
Nonoperatively managed small- to medium-sized subscapularis tendon tears: magnetic resonance imaging evaluation with a minimum of 5 years of follow-up.

JSES Int. 2021-10-21

[4]
Morphology of the coracoid process as a predictor of articular-side tear at the upper border of the subscapularis.

J Shoulder Elbow Surg. 2022-7

[5]
Risk Factors for Supraspinatus Tears: A Meta-analysis of Observational Studies.

Orthop J Sports Med. 2021-10-12

[6]
Arthroscopic Revision Rotator Cuff Repair: The Role of Previously Neglected Subscapularis Tears.

Am J Sports Med. 2021-12

[7]
Medium- to long-term clinical and functional outcomes of isolated and combined subscapularis tears repaired arthroscopically.

Arch Med Sci. 2020-7-28

[8]
What Factors Are Associated with Symptomatic Rotator Cuff Tears: A Meta-analysis.

Clin Orthop Relat Res. 2022-1-1

[9]
Bilateral coracohumeral distance discrepancy is associated with subscapularis tear in rotator cuff rupture patients.

Knee Surg Sports Traumatol Arthrosc. 2021-12

[10]
Muscle volume imbalance may be associated with static posterior humeral head subluxation.

BMC Musculoskelet Disord. 2021-3-15

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