Tan Ashton Kai Shun, Chung Isaac De Wei, Lee Wen Qiang, Lie Denny Tijauw Tjoen
Department of Orthopaedic Surgery, Singapore General Hospital, Singapore, Singapore.
Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.
JSES Rev Rep Tech. 2024 May 21;4(3):379-384. doi: 10.1016/j.xrrt.2024.04.015. eCollection 2024 Aug.
This paper aims to conduct a systematic review of the current literature to evaluate the clinical outcomes of concurrent latissimus dorsi and teres major (LD/TM) tendon transfer in reverse shoulder arthroplasty (RSA), and to compare that to isolated RSA.
A comprehensive search on PubMeb, Web of Science, Embase and CINAHL was performed from inception up to January 20, 2023, in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses. Cohort studies, case-control studies, randomized controlled trials and case series that were written in English, which involved patients who underwent RSA with LD/TM transfer were included. Quality of studies was appraised using the Cochrane Risk Of Bias In Nonrandomized Studies of Interventions tool. Systematic review of Constant-Murley Score (CMS) and range of movement (ROM) was conducted.
Eight studies with a total of 265 patients were included. The average mean follow-up time was 42.5 months, with a range of 6 months to 136 months. Of the studies that reported outcomes of RSA with LD/TM transfer, five reported the CMS, five reported external rotation (ER) ROM and six reported forward flexion ROM. Comparing postoperative to preoperative scores, there was an improvement above the minimal clinically important difference for CMS (mean difference (MD) range = 22.40 to 41.80), ER (MD range = 29° to 36°) and forward flexion (MD range = 50° to 75°). Three studies that compared postoperative ER between RSA with and without LD/TM reported no significant difference.
RSA with LD/TM transfer has good clinical outcomes postoperatively, but there is insufficient comparative data to suggest that it is superior or inferior to an isolated RSA.
本文旨在对当前文献进行系统综述，以评估在反肩关节置换术（RSA）中同时进行背阔肌和大圆肌（LD/TM）肌腱转移的临床结果，并将其与单纯RSA进行比较。
按照系统评价和Meta分析的首选报告项目，从数据库建立至2023年1月20日，在PubMed、科学网、Embase和CINAHL上进行全面检索。纳入用英文撰写的队列研究、病例对照研究、随机对照试验和病例系列，这些研究涉及接受LD/TM转移的RSA患者。使用Cochrane干预非随机研究中的偏倚风险工具评估研究质量。对Constant-Murley评分（CMS）和活动范围（ROM）进行系统评价。
纳入8项研究，共265例患者。平均随访时间为42.5个月，范围为6个月至136个月。在报告了LD/TM转移的RSA结果的研究中，5项报告了CMS，5项报告了外旋（ER）ROM，6项报告了前屈ROM。与术前评分相比，CMS（平均差值（MD）范围=22.40至41.80）、ER（MD范围=29°至36°）和前屈（MD范围=50°至75°）均有超过最小临床重要差异的改善。3项比较有和没有LD/TM转移的RSA术后ER的研究报告无显著差异。
LD/TM转移的RSA术后有良好的临床结果，但缺乏足够的比较数据表明其优于或劣于单纯RSA。
