Liang Jun-Wen, Yang Zhi-Tao, Liu Tao, Wang Xi-Hao, Fang Sen, Zhang Bai-Rong, Yun Xiang-Dong
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China.
Department of Orthopaedics, the Second Hospital of Lanzhou University, Lanzhou 730030, Gansu, China; Key Laboratory of Bone and Joint Disease of Gansu Province, Lanzhou 730030, Gansu, China.
Zhongguo Gu Shang. 2023 Dec 25;36(12):1196-202. doi: 10.12200/j.issn.1003-0034.2023.12.017.
To systematically evaluate obesity on the outcome of rotator cuff repair.
Literatures on the relationship between obesity and outcomes after rotator cuff repair were searched from PubMed, Embase, Cochrane Library, Web of Science, China biology medicine(CBM), CNKI, Wanfang and VIP databases from building database to August 1, 2022, and were screened independently by two authors according to inclusion and exclusion criteria. Endnote X9 and Excel 2019 were used for literature extraction, management and data entry, and Newcastle-Ottawa Scale (NOS) was used to evaluate quality of the included literatures. STATA 16.0 and RevMan 5.4 softwares were used to evaluate postoperative retear rate, reoperation rate, complication rate, American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale (VAS), operative time and external rotation angle of shoulder joint pain were analyzed.
Totally 13 literatures were included, including 6 retrospective studies, 5 case-control studies, 1 prospective cohort study, and 1 abstract of a study for which the full text was not available, with 85 503 patients (31 973 in obese group and 53 530 in non-obese group). Meta-analysis showed there were statistical differences between two groups in retear rate [=2.58, 95%(1.23, 5.41), =0.01], reoperation rate[=1.31, 95%(1.21, 1.42), <0.00], complication rate [=1.57, 95%(1.31, 1.87), =0.00], ASES score[=-3.59, 95%(-5.45, -1.74), =0.00], and VAS[=0.24, 95%(0.00, 0.49), =0.05]. While there were no differences between two groups in operative time[=6.03, 95%(-7.63, 19.69), =0.39], external rotation angle of shoulder joint[=-1.79, 95%(-5.30, 1.71), =0.32].
Obesity is associated with higher rates of retear, resurgery, complications, poorer shoulder function and pain after rotator cuff repair.
系统评价肥胖对肩袖修复术结局的影响。
从建库至2022年8月1日，检索PubMed、Embase、Cochrane图书馆、Web of Science、中国生物医学文献数据库（CBM）、中国知网、万方数据库和维普数据库中有关肥胖与肩袖修复术后结局关系的文献，由两名作者根据纳入和排除标准独立筛选。使用Endnote X9和Excel 2019进行文献提取、管理和数据录入，采用纽卡斯尔-渥太华量表（NOS）评估纳入文献的质量。使用STATA 16.0和RevMan 5.4软件分析术后再撕裂率、再次手术率、并发症发生率、美国肩肘外科医师（ASES）评分、视觉模拟评分法（VAS）、手术时间以及肩关节疼痛时的外旋角度。
共纳入13篇文献，其中回顾性研究6篇、病例对照研究5篇、前瞻性队列研究1篇、1篇文献仅有摘要而无全文，共涉及85503例患者（肥胖组31973例，非肥胖组53530例）。Meta分析显示，两组在再撕裂率[比值比（OR）=2.58，95%可信区间（CI）（1.23，5.41），P=0.01]、再次手术率[OR=1.31，95%CI（1.21，1.42），P<0.001]、并发症发生率[OR=1.57，95%CI（1.31，1.87），P=0.001]、ASES评分[平均差（MD）=-3.59，95%CI（-5.45，-1.74），P=0.001]及VAS评分[MD=0.24，95%CI（0.00，0.49），P=0.05]方面存在统计学差异。而两组在手术时间[MD=6.03，95%CI（-7.63，19.69），P=0.39]、肩关节外旋角度[MD=-1.79，95%CI（-5.30，1.71），P=0.32]方面无差异。
肥胖与肩袖修复术后较高的再撕裂率、再次手术率、并发症发生率、较差的肩部功能及疼痛相关。
