下斜方肌腱转移改善不可修复的肩袖撕裂的活动范围、功能结果和疼痛:系统回顾。

IF 4.4 1区 医学 Q1 ORTHOPEDICS
Bradley J Lauck, Alan W Reynolds, Jelle P van der List, Nicholas A Trasolini, Brian R Waterman
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引用次数: 0

摘要

目的:分析关于下斜方肌腱转移(LTT)治疗功能性不可修复的肩袖撕裂(FIRCT)的现有文献,并总结该手术的结果。方法:2024年4月4日,按照PRISMA指南在MEDLINE、CINAHL、Embase和SPORTDiscus数据库中进行了系统评价,以确定LTT治疗FIRCT的临床结果研究。证据水平为IV或更高的同行评审出版物被纳入。记录与临床结果和并发症相关的数据。使用非随机研究方法学指数(minor)评估偏倚风险。结果:最初的检索产生了1066项研究,最终纳入了15项研究,包括393名患者。平均随访3 ~ 58.2个月。所有的研究都报道了FIRCT LTT后患者报告的结果和活动范围的显著改善。术后美国肩肘外科医生(American Shoulder and Elbow Surgeons, ASES)评分为54.8 ~ 84.8分,绝对改善21.7 ~ 48.6分,视觉模拟量表(Visual analogue Scale, VAS)疼痛评分改善1.7 ~ 5.4分。术后外旋范围为35°至101.7°,平均改善11°至32.5°,前屈改善7.9°至66°,范围为120°至165.7°。12项研究报告了并发症,LTT复发(范围0-19%)和感染(0-13%)是最常见的。10项研究中发生了再手术,最常见的是转行肩关节置换术(0-20%)。结论:下斜方肌腱转移是治疗功能性不可修复的肩袖撕裂的可靠选择,可显著改善临床和功能预后。它在恢复外旋方面特别有效,并发症和再手术率与其他外科手术相当。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Lower Trapezius Tendon Transfer Improves Range of Motion, Functional Outcomes, and Pain for Irreparable Rotator Cuff Tears: A Systematic Review.

Purpose: To analyze the available literature on lower trapezius tendon transfer (LTT) for functionally irreparable rotator cuff tears (FIRCTs) and summarize the outcomes of this procedure.

Methods: A systematic review was conducted on April 4, 2024, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines in the MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, and SPORTDiscus databases to identify clinical outcome studies on LTT for FIRCTs. Peer-reviewed publications with a level of evidence of Level IV or higher were included. Data related to clinical outcomes and complications were recorded. Risk of bias was assessed using the Methodological Index for Non-randomized Studies.

Results: The initial search yielded 1,066 studies, resulting in 15 studies for inclusion, including 393 total patients. Mean follow-up ranged from 3 to 58.2 months. All studies reported significant improvements in patient-reported outcomes and range of motion after LTT for FIRCTs. Postoperative American Shoulder and Elbow Surgeons scores ranged from 54.8 to 84.8, with absolute improvements of 21.7 to 48.6, whereas visual analog scale pain scores improved by 1.7 to 5.4. Postoperative external rotation ranged from 35° to 101.7°, with mean improvements of 11° to 32.5°, and forward flexion improved by 7.9° to 66° to a range of 120° to 165.7°. Complications were reported in 12 studies, with LTT retear (range, 0%-19%) and infection (0%-13%) being the most common. Reoperations occurred in 10 studies, most frequently consisting of conversion to shoulder arthroplasty (0%-20%).

Conclusions: LTT is a reliable option for FIRCTs, offering significant improvements in clinical and functional outcomes. It is particularly effective in restoring external rotation, with complication and reoperation rates comparable to alternative surgical procedures.

Level of evidence: Level IV, systematic review of Level III and IV studies.

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来源期刊
CiteScore
9.30
自引率
17.00%
发文量
555
审稿时长
58 days
期刊介绍: Nowhere is minimally invasive surgery explained better than in Arthroscopy, the leading peer-reviewed journal in the field. Every issue enables you to put into perspective the usefulness of the various emerging arthroscopic techniques. The advantages and disadvantages of these methods -- along with their applications in various situations -- are discussed in relation to their efficiency, efficacy and cost benefit. As a special incentive, paid subscribers also receive access to the journal expanded website.
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