Retear rates after rotator cuff surgery: a systematic review and meta-analysis.
Retear rates after rotator cuff surgery: a systematic review and meta-analysis.
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DOI：
10.1186/s12891-021-04634-6
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发表时间：
2021-08-31
影响因子：
2.3
通讯作者：
Denaro V
中科院分区：
文献类型：
--
作者：
Longo UG;Carnevale A;Piergentili I;Berton A;Candela V;Schena E;Denaro V
肩袖撕裂（RCR）是术后主要的缺陷之一。RCR可以被认为是一个多因素的问题，其原因既与生物因素有关，也与生物力学因素有关。本研究的目的是确定手术后不同时间点RCR的发生率，并确定影响术后旋转袖（RC）愈合的主要因素。按照PRISMA指南进行系统评价和荟萃分析。2020年7月，使用PubMed和Cochrane图书馆数据库对文献进行了全面检索。仅纳入1级和2级临床证据研究。如果术前可修复的全层RC撕裂患者接受手术治疗，以及如果研究报告术后RCR经影像学诊断证实，则纳入研究。使用汇总数据的反方差方法，研究了复习时间与随访时间点之间的关系。亚组荟萃分析采用DerSimonian和Laird方法估计研究间方差，即τ2。术后撕裂率与患者年龄、术前撕裂大小、脂肪浸润、术后康复方案、手术技术和RC修复之间的关系通过以95%可信区间（CI）的优势比（OR）表示效果度量来确定。采用95% ci的Mantel-Haenszel方法。本研究共纳入31篇文章。术后RCR在随访3个月时为15%，随访3 - 6个月时为21%，随访6-12个月时为16%，随访12-24个月时为21%，随访超过24个月时为16%。影响RC愈合的主要因素既与患者相关（如年龄、撕裂较大、脂肪浸润），也与患者无关（如术后康复方案、手术技术和手术程序）。术后RC愈合受患者相关和非患者相关因素的影响。需要进一步的高水平临床研究来提供高度相关的临床结果。在线版本包含补充材料，可在10.1186/s12891-021-04634-6获得。
Rotator cuff retear (RCR) is one of the main postoperative drawbacks. RCR can be considered a multifactorial issue, which causes are related either to biological than biomechanical factors. The aim of this study was to define the incidence of RCR after surgical treatment at different time points and to identify the main factors influencing the postoperative rotator cuff (RC) healing. A systematic review and meta-analysis were performed following the PRISMA guidelines. A comprehensive search of the literature was carried out in July 2020, using PubMed and Cochrane Library databases. Only level 1 and 2 clinical evidence studies were included. Studies were included if patients with preoperative repairable full-thickness RC tears were treated surgically, and if studies reported postoperative RCR confirmed by imaging diagnostic. The association between timing of retear and follow-up time points were investigated using an inverse-variance method of pooling data. A subgroup meta-analysis was performed using the DerSimonian and Laird method for the estimation of the between-study variance, i.e., τ2. The association between retear rate after surgery and patients’ age, preoperative tear size, fatty infiltration, postoperative rehabilitation protocol, surgical techniques, and RC repairs was determined by expressing the effect measure in terms of odds ratio (OR) with 95% confidence interval (CI). The Mantel-Haenszel method with 95% CIs was used. Thirty-one articles were included in this study. The percentage of RCR after surgery was 15% at 3 months follow-up, 21% at 3–6 months follow-up, 16% at 6–12 months follow-up, 21% at 12–24 months follow-up, 16% at follow-up longer than 24 months. The main factors influencing RC healing are both patient-related (i.e., age, larger tear size, fatty infiltration) and not patient-related (i.e., postoperative rehabilitation protocol, surgical techniques, and procedures). Postoperative RC healing is influenced by patient-related and non-patient-related factors. Further high-level clinical studies are needed to provide highly relevant clinical results. The online version contains supplementary material available at 10.1186/s12891-021-04634-6.
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影响因子：
4.8
作者：
Cai, You-Zhi;Zhang, Chi;Chen, Jian-De
通讯作者：
Chen, Jian-De
影响因子：
4.8
作者：
Cho, Nam Su;Moon, Seong Cheol;Rhee, Yong Girl
通讯作者：
Rhee, Yong Girl
影响因子：
4.6
作者：
Carr, A.;Cooper, C.;Ramsay, C.
通讯作者：
Ramsay, C.
DOI：
10.1016/j.arthro.2011.06.038
发表时间：
2012-01-01
影响因子：
4.7
作者：
Barber, F. Alan;Burns, Joseph P.;Litchfield, Robert B.
通讯作者：
Litchfield, Robert B.
影响因子：
3
作者：
Avanzi, Paolo;dei Giudici, Luca;Zorzi, Claudio
通讯作者：
Zorzi, Claudio