Reduced retear rates yet similar clinical outcomes following arthroscopic partial repair of large and massive irreparable rotator cuff tears with biceps augmentation compared to repairs without biceps augmentation: A systematic review and meta-analysis

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2024-08-27 DOI:10.1002/ksa.12440

Napatpong Thamrongskulsiri, Danaithep Limskul, Thanathep Tanpowpong, Somsak Kuptniratsaikul, Thun Itthipanichpong

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引用次数: 0

Abstract

Purpose

To compare the clinical outcomes between arthroscopic partial rotator cuff repair with biceps augmentation (BA) and partial repair (PR) without BA.

Methods

This systematic review included studies comparing outcomes of arthroscopic repair for large to massive irreparable rotator cuff tears with and without the BA. The focus was on postoperative clinical results and retear rates. Mean differences were used to express continuous outcomes, while odds ratios (ORs) were employed for dichotomous outcomes.

Results

Ten studies (733 shoulders, all level 3 evidence) were included. The BA group showed a significant reduction in retear rates (OR = 0.40, 95% confidence interval [CI]: 0.20–0.77, P = 0.007) and comparable postoperative outcomes across various measures: American Shoulder and Elbow Surgeons (ASES) score, visual analogue scale for pain, University of California-Los Angeles shoulder score, active forward flexion motion and active external rotation at the arm-at-side position compared to the PR group. Subgroup analysis of two BA techniques—rerouting and supplementation following supraglenoid tenotomy—showed no significant differences in ASES score for either technique versus PR. However, rerouting significantly lowered retear rates (OR = 0.21, 95% CI: 0.12–0.36, p < 0.001), while supplementation showed similar retear rates to PR (OR = 0.87, 95% CI: 0.37–2.02, n.s.).

Conclusion

Arthroscopic partial rotator cuff repair with BA for large to massive irreparable rotator cuff tears is a reliable technique, resulting in improved postoperative outcomes. BA using supplementation following supraglenoid tenotomy showed similar clinical outcomes and range of motion but with lower retear rates compared to the PR group.

Level of Evidence

Level III.

查看原文本刊更多论文

与不进行肱二头肌增强的修复术相比，进行肱二头肌增强的关节镜下部分修复大面积和大量不可修复的肩袖撕裂后，再撕裂率降低，但临床疗效相似：系统回顾和荟萃分析。

目的：比较带肱二头肌增生（BA）的关节镜肩袖部分修复术和不带BA的肩袖部分修复术的临床疗效：该系统性综述纳入了对使用和不使用肱二头肌增强器的大面积不可修复肩袖撕裂关节镜修复术的疗效进行比较的研究。重点是术后临床结果和再撕裂率。平均差用于表示连续性结果，几率比（OR）用于表示二分法结果：结果：共纳入 10 项研究（733 个肩部，均为 3 级证据）。BA组的再撕裂率明显降低（OR=0.40，95%置信区间[CI]：0.20-0.77，P=0.007），各种指标的术后效果相当：美国肩肘外科医生（ASES）评分、疼痛视觉模拟量表、加利福尼亚大学洛杉矶分校肩关节评分、主动前屈运动和手臂侧位主动外旋运动与 PR 组相比，术后效果相当。对两种BA技术进行分组分析后发现，两种技术的ASES评分与PR相比没有显著差异。不过，改道术明显降低了再撕裂率（OR = 0.21，95% CI：0.12-0.36，P 结论：改道术可显著降低再撕裂率：关节镜下肩袖部分修复术加BA治疗大面积至大量不可修复的肩袖撕裂是一种可靠的技术，可改善术后效果。与PR组相比，在raglenoid上腱膜切除术后使用BA进行补充治疗的临床疗效和活动范围相似，但再撕裂率较低：证据等级：三级。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Knee Surgery, Sports Traumatology, Arthroscopy 医学-外科

CiteScore

8.10

自引率

18.40%

发文量

418

审稿时长

2 months

期刊介绍： Few other areas of orthopedic surgery and traumatology have undergone such a dramatic evolution in the last 10 years as knee surgery, arthroscopy and sports traumatology. Ranked among the top 33% of journals in both Orthopedics and Sports Sciences, the goal of this European journal is to publish papers about innovative knee surgery, sports trauma surgery and arthroscopy. Each issue features a series of peer-reviewed articles that deal with diagnosis and management and with basic research. Each issue also contains at least one review article about an important clinical problem. Case presentations or short notes about technical innovations are also accepted for publication. The articles cover all aspects of knee surgery and all types of sports trauma; in addition, epidemiology, diagnosis, treatment and prevention, and all types of arthroscopy (not only the knee but also the shoulder, elbow, wrist, hip, ankle, etc.) are addressed. Articles on new diagnostic techniques such as MRI and ultrasound and high-quality articles about the biomechanics of joints, muscles and tendons are included. Although this is largely a clinical journal, it is also open to basic research with clinical relevance. Because the journal is supported by a distinguished European Editorial Board, assisted by an international Advisory Board, you can be assured that the journal maintains the highest standards. Official Clinical Journal of the European Society of Sports Traumatology, Knee Surgery and Arthroscopy (ESSKA).