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使用缝线纽扣治疗急性重度肩锁关节脱位的关节镜手术与开放手术比较:一项系统评价和荟萃分析

Comparison of the arthroscopic and open surgery for the treatment of acute high-grade acromioclavicular joint dislocation using suture button: a systematic review and meta-analysis.

作者信息

Ye Jiajing, Yao Can, Ge Yanan, Huang Lingqin, Chen Cong, Luo Hua

机构信息

Department of Orthopedic, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, Zhejiang, China.

Department of Ultrasound, Taizhou Second People's Hospital, Taizhou, Zhejiang, China.

出版信息

EFORT Open Rev. 2025 Sep 4;10(9):671-678. doi: 10.1530/EOR-2024-0067.

Abstract

PURPOSE

To conduct a meta-analysis of clinical studies evaluating the efficacy and safety of arthroscopic and open surgery for the treatment of acute high-grade acromioclavicular joint (ACJ) dislocation using a suture button.

METHODS

The review process was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Two independent reviewers conducted the literature searches based on preferred reporting items from systematic reviews and meta-analyses. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched for studies comparing arthroscopic and open surgery for the treatment of acute high-grade ACJ dislocation using a suture button. Constant score, visual analog scale, coracoclavicular distance, acromioclavicular distance, operation time, and occurrence of complications were analyzed.

RESULTS

Five studies comprising a total of 198 patients were included in this study. The findings revealed that, in comparison to open fixation, arthroscopic fixation resulted in longer surgical durations. However, there were no significant differences between the two techniques in terms of constant score, visual analog scale, coracoclavicular distance, acromioclavicular distance, or the occurrence of complications.

CONCLUSIONS

Based on current evidence, arthroscopic fixation demonstrates comparable postoperative outcomes to open fixation, albeit with longer surgical durations. With ongoing technological advancements and refinement of surgical techniques, the efficiency and accessibility of arthroscopy are expected to improve, potentially solidifying its role as a superior choice in the future.

摘要

目的

进行一项荟萃分析,以评估使用缝合纽扣进行关节镜手术和开放手术治疗急性重度肩锁关节(ACJ)脱位的疗效和安全性。

方法

根据系统评价和荟萃分析的首选报告项目(PRISMA)指南进行综述过程。两名独立评审员根据系统评价和荟萃分析的首选报告项目进行文献检索。在PubMed、EMBASE、科学网和Cochrane图书馆中检索比较使用缝合纽扣进行关节镜手术和开放手术治疗急性重度ACJ脱位的研究。分析Constant评分、视觉模拟量表、喙锁距离、肩锁距离、手术时间和并发症的发生情况。

结果

本研究纳入了5项研究,共198例患者。研究结果显示,与开放固定相比,关节镜固定导致手术时间更长。然而,在Constant评分、视觉模拟量表、喙锁距离、肩锁距离或并发症的发生方面,两种技术之间没有显著差异。

结论

根据目前的证据,关节镜固定显示出与开放固定相当的术后结果,尽管手术时间更长。随着技术的不断进步和手术技术的完善,关节镜检查的效率和可及性有望提高,这可能会巩固其在未来作为更优选择的地位。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5d24/12412284/2b3243466310/EOR-2024-0067fig1.jpg

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