大量不可修复的后上肩袖撕裂的非关节成形术治疗:系统回顾和荟萃分析。

IF 1.1 Q3 ORTHOPEDICS
Rafael Fernando Serrano-Sánchez, Arnovis Colina Ortega, Ana Marcela Piña Quintero, Luis F Giraldo-Cadavid
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引用次数: 0

摘要

大量不可修复的后上肩袖撕裂(mrct)由于肌腱缩回、脂肪浸润、肌肉萎缩和组织质量差,给临床和手术带来了挑战。非关节置换术已成为肩关节置换术的替代选择。方法:我们进行了一项系统综述和荟萃分析,比较研究评估非关节成形术治疗的mrct。我们检索了PubMed、LILACS、Scopus和谷歌Scholar,包括随访至少12个月的研究。提取功能结果、活动范围和并发症发生率。使用ROBINS-I评估偏倚风险。结果:21项研究(n = 1036例患者)纳入,评估部分修复,肌腱转移,上囊重建(SCR),清创,增强和肩峰下球囊间隔。所有技术均显示功能改善和疼痛减轻。部分修复的外旋效果优于增强术。肌腱转移和SCR产生相似的功能结果。增强术并发症发生率最高(33%),清创最低(10%)。这些发现可能反映了基线病理严重程度和手术技术的相对复杂性的差异。结论:mrct的非关节成形术选择提供了显著的功能增强和疼痛缓解。没有一种技术显示出明显的优势。总体证据质量较低,强调未来需要高质量的比较研究来优化治疗策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Nonarthroplasty surgical management of massive irreparable posterosuperior rotator cuff tears: A systematic review and meta-analysis.

Introduction: Massive irreparable posterosuperior rotator cuff tears (MRCTs) pose clinical and surgical challenges due to tendon retraction, fatty infiltration, muscle atrophy, and poor tissue quality. Nonarthroplasty options have emerged as alternatives to shoulder arthroplasty.

Methods: We conducted a systematic review and meta-analysis of comparative studies evaluating nonarthroplasty surgical treatments for MRCTs. We searched PubMed, LILACS, Scopus, and Google Scholar, including studies with at least 12 months of follow up. Functional outcomes, range of motion, and complication rates were extracted. Risk of bias was assessed using ROBINS-I.

Results: Twenty-one studies (n = 1036 patients) were included, evaluating partial repair, tendon transfers, superior capsular reconstruction (SCR), debridement, augmentation, and subacromial balloon spacers. All techniques showed functional improvement and pain reduction. Partial repair showed better external rotation than augmentation. Tendon transfers and SCR yielded similar functional outcomes. Augmentations had the highest complication rate (33%), while debridement the lowest (10%). These findings may reflect differences in baseline pathology severity and the relative complexity of the surgical techniques.

Conclusion: Nonarthroplasty surgical options for MRCTs provide significant functional gains and pain relief. No technique demonstrated clear superiority. Overall evidence quality was low, highlighting the need for future high-quality comparative studies to optimize treatment strategies.

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来源期刊
Shoulder and Elbow
Shoulder and Elbow Medicine-Rehabilitation
CiteScore
2.80
自引率
0.00%
发文量
91
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