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肩锁关节脱位及合并的盂唇损伤:一项系统评价

Acromioclavicular joint dislocation and concomitant labral lesions: a systematic review.

作者信息

Mansour Jad, Nassar Joseph E, Estephan Michel, Boulos Karl, Daher Mohammad

机构信息

Division of Orthopedic Surgery and Sports Medicine, McGill University Health Centre, Montreal, QC, Canada.

American University of Beirut, Beirut, Lebanon.

出版信息

Clin Shoulder Elb. 2024 Jun;27(2):247-253. doi: 10.5397/cise.2023.00640. Epub 2024 Jan 26.

Abstract

Acromioclavicular (AC) joint dislocations frequently co-occur with intra-articular glenohumeral pathologies. Few comprehensive studies have focused on labral tears specifically associated with AC joint trauma. This systematic review will address this gap. A comprehensive electronic search was conducted across PubMed, Cochrane Library, and Google Scholar (pages 1-20) spanning from 1976 to May 19, 2023. Seven studies met the inclusion criteria for this systematic review, consisting of three retrospective studies and four case series. These studies collectively involved 1,044 patients, of whom 282 had concomitant labral lesions. The pooled prevalence of intra-articular labral injuries associated with acute AC joint dislocation was 27%. The prevalence of these labral lesions varied significantly between studies, ranging from 13.9% to 84.0% of patients, depending on the study and the grade of AC joint dislocation. Various types of labral tears were reported, with superior labrum anterior to posterior (SLAP) lesions being the most common. The prevalence of SLAP lesions ranged from 7.2% to 77.4%, with higher grades of AC joint dislocations often associated with a higher prevalence of SLAP tears. Moreover, grade V dislocations exhibited a complete correlation with SLAP tears. The studies yielded contradictory findings regarding older age and higher grades of AC joint dislocation as risk factors for concurrent labral lesions. This review underscores the frequent association between labral lesions and AC joint dislocations, particularly in cases of lower-grade injuries. Notably, SLAP lesions emerged as the predominant type of labral tear.

摘要

肩锁关节(AC)脱位常与盂肱关节内病变同时发生。很少有全面的研究专门关注与AC关节创伤相关的盂唇撕裂。本系统评价将填补这一空白。我们在PubMed、Cochrane图书馆和谷歌学术(第1 - 20页)上进行了全面的电子检索,检索时间跨度为1976年至2023年5月19日。七项研究符合本系统评价的纳入标准,包括三项回顾性研究和四个病例系列。这些研究共涉及1044例患者,其中282例伴有盂唇损伤。急性AC关节脱位相关的关节内盂唇损伤的合并患病率为27%。这些盂唇损伤的患病率在不同研究之间差异显著,根据研究和AC关节脱位的分级,患者患病率在13.9%至84.0%之间。报告了各种类型的盂唇撕裂,其中前上盂唇从前到后的(SLAP)损伤最为常见。SLAP损伤的患病率在7.2%至77.4%之间,AC关节脱位分级越高,SLAP撕裂的患病率往往越高。此外,V级脱位与SLAP撕裂完全相关。关于年龄较大和AC关节脱位分级较高作为并发盂唇损伤的危险因素,这些研究得出了相互矛盾的结果。本综述强调了盂唇损伤与AC关节脱位之间的频繁关联,特别是在低级别损伤的情况下。值得注意的是,SLAP损伤是盂唇撕裂的主要类型。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/045f/11181061/74bd579de64f/cise-2023-00640f1.jpg

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