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在治疗巨大肩袖撕裂中部分修复与上盂唇重建的比较:当前证据的荟萃分析

Partial repair versus superior capsule reconstruction in managing massive rotator cuff tears. A meta-analysis of the current evidence.

作者信息

Khalafallah Mohamed A, Mohamed Mohamed I, Farrag Mohamed M, Bishara Hazem A, Muir Duncan, Narvani Ali, Calvo Emilio, Imam Mohamed A

机构信息

Faculty of Medicine, Alexandria University, Alexandria, Egypt.

East Surrey Hospital, Surrey and Sussex NHS Trust, Redhill, UK.

出版信息

Shoulder Elbow. 2025 May 29:17585732251345137. doi: 10.1177/17585732251345137.

Abstract

BACKGROUND

Rotator cuff tear (RCT) is a common musculoskeletal condition. Managing RCTs can be challenging. Initial treatments typically involve conservative approaches such as physical therapy and corticosteroid injections. This meta-analysis compared the functional and clinical outcomes of two surgical techniques, Partial Repair (PR) and Superior Capsular Reconstruction (SCR), for managing rotator cuff tears.

METHODS

The search included studies published in PubMed, Scopus, Web of Science, and Cochrane Library databases from 2013 to 2023. Studies comparing SCR with PR techniques in rotator cuff tear patients were included. Primary outcome was Constant shoulder score.

RESULTS

Four cohort studies, totaling 235 patients, were included and analysed. There were no statistically significant differences between SCR and PR groups in constant shoulder score ( = 0.12), disabilities of the arm, shoulder, and hand ( = 0.42), acromiohumeral distance ( = 0.61), re-operation rate ( = 0.33), forward flexion ( = 0.73), and Visual Analog Score (VAS) score ( = 0.69). Heterogeneity was observed in some outcomes.

DISCUSSION

Based on the available low level of evidence and observed heterogeneity, this meta-analysis did not identify significant disparities in functional and clinical outcomes between SCR and PR. Further high-quality clinical trials with larger sample sizes are warranted to confirm these findings.

摘要

背景

肩袖撕裂(RCT)是一种常见的肌肉骨骼疾病。处理肩袖撕裂可能具有挑战性。初始治疗通常采用保守方法,如物理治疗和皮质类固醇注射。本荟萃分析比较了两种手术技术,即部分修复(PR)和上盂唇重建(SCR)在治疗肩袖撕裂方面的功能和临床结果。

方法

检索了2013年至2023年发表在PubMed、Scopus、科学网和考克兰图书馆数据库中的研究。纳入了比较肩袖撕裂患者中SCR与PR技术的研究。主要结局是Constant肩关节评分。

结果

纳入并分析了四项队列研究,共235例患者。SCR组和PR组在Constant肩关节评分(=0.12)、手臂、肩部和手部功能障碍(=0.42)、肩峰下间隙(=0.61)、再次手术率(=0.33)、前屈(=0.73)和视觉模拟评分(VAS)评分(=0.69)方面无统计学显著差异。在一些结局中观察到异质性。

讨论

基于现有低质量证据和观察到的异质性,本荟萃分析未发现SCR和PR在功能和临床结果上存在显著差异。需要进一步开展更大样本量的高质量临床试验来证实这些发现。

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