Revision rates and progression to shoulder arthroplasty after arthroscopic repair of massive rotator cuff tears.

IF 3.3 2区医学 Q1 ORTHOPEDICS

Knee Surgery, Sports Traumatology, Arthroscopy Pub Date : 2025-04-01 DOI:10.1002/ksa.12651

Umile Giuseppe Longo, Alberto Lalli, Benedetta Bandini, Alice Piccolomini, Nathan S Ullman, Andrea Vaiano, Pieter D'Hooghe

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引用次数: 0

Abstract

Purpose: The purpose of this systematic review was to assess the rate of progression to reverse total shoulder arthroplasty (RTSA) and to other interventions as revision surgeries after an arthroscopic repair of a massive rotator cuff tear (MRCT). Additionally, the review aimed at defining the best arthroscopic approach for the treatment of MRCTs in terms of failure and revision rates.

Methods: The purpose of this systematic review and meta-analysis was to evaluate the rates of progression to reverse total shoulder arthroplasty in patients who underwent primary arthroscopic repair of an MRCT with different arthroscopic procedures. A meta-analysis was performed to compare the rate of progression to revision surgery and reverse total shoulder arthroplasty.

Results: Eighteen articles were included in the qualitative synthesis and 14 articles were included in the meta-analysis. Overall, 934 patients and 950 shoulders were involved in the review. Seven-hundred and thirty patients and 735 shoulders were included in the meta-analysis. The proportion of revisions to reverse total shoulder arthroplasty was 0.9%, 3.3% and 0.1% for complete repair, partial repair and superior capsular reconstruction, respectively. No statistically significant differences were found across the groups in terms of progression to reverse total shoulder arthroplasty (n.s.). The average proportions of revisions to interventions different than reverse total shoulder arthroplasty. were 0.9% for complete repair, 2.0% for partial repair and 2.0% for superior capsular reconstruction again, no statistically relevant difference was found among the groups (n.s.).

Conclusions: The current review finds no statistically significant differences in the progression to reverse total shoulder arthroplasty or other revision procedures among partial repair, complete repair and superior capsular reconstruction for massive irreparable rotator cuff tears. It is crucial to understand the long-term outcomes of different surgical techniques for massive rotator cuff tears, particularly regarding failure rates and progression to further procedures.

Level of evidence: Level IV.

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肩关节镜下大面积肩袖撕裂修复后肩关节置换术的翻修率和进展。

目的：本系统综述的目的是评估关节镜下修复大面积肩袖撕裂（MRCT）后进行反向全肩关节置换术（RTSA）和其他干预措施翻修手术的进展率。此外，该综述旨在从失败和翻修率方面确定治疗mrct的最佳关节镜入路。方法：本系统综述和荟萃分析的目的是评估采用不同关节镜手术方式进行MRCT初级关节镜修复的患者逆转全肩关节置换术的进展率。进行了一项荟萃分析来比较翻修手术和反向全肩关节置换术的进展率。结果：18篇文章被纳入定性综合，14篇文章被纳入meta分析。总的来说，934名患者和950名肩部参与了该综述。730名患者和735个肩部被纳入meta分析。完全修复、部分修复和上囊重建对反向全肩关节置换术的修正比例分别为0.9%、3.3%和0.1%。在逆转全肩关节置换术的进展方面，两组间没有统计学上的显著差异。干预翻修的平均比例不同于反向全肩关节置换术。完全修复率为0.9%，部分修复率为2.0%，再次上囊重建率为2.0%，组间无统计学差异（ns）。结论：目前的综述发现，对于大量不可修复的肩袖撕裂，部分修复、完全修复和上囊重建，在逆行全肩关节置换术或其他翻修手术的进展方面没有统计学上的显著差异。了解不同手术技术治疗大规模肩袖撕裂的长期结果是至关重要的，特别是失败率和进一步手术的进展。证据等级：四级。

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).