在解剖学全肩关节整形术中进行下骨头管理:系统性审查和网络元分析
Abdulaziz F Ahmed1, Randall T Kreulen1, Jacob Mikula1
1Department of Orthopaedic Surgery, Johns Hopkins Medicine, Howard County General Hospital, Columbia, MD, USA.
Shoulder & elbow
|September 11, 2023
概括
在肩膀全关节整形术中,小结节骨切除和 subscapularis 剥皮技术显示出比 subscapularis 切除更好的结果和愈合率. 这些方法可以改善肩膀功能和生活质量.
科学领域:
- 整形外科手术 整形外科手术
- 生物机械工程 生物机械工程
- 临床结果研究研究
背景情况:
- 肩下关节管的管理对于解剖学全肩关节整形术 (aTSA) 的结果至关重要.
- 有三种主要的技术:较小的结核骨切除术 (LTO), subscapularis剥皮 (SP) 和 subscapularis切除术 (ST).
- 在aTSA中对这些技术的比较数据有限.
研究的目的:
- 在aTSA中系统地审查和网络分析LTO,SP和ST的临床结果.
- 为了比较功能分数,运动范围和治愈速度,在三个 subscapularis 管理技术.
- 在aTSA中确定最佳的外科手术策略,以保护或修复 subscapularis.
主要方法:
- 在PubMed,Web of Science,Embase和Cochrane的试验注册表中进行系统的文献搜索 (2021年7月).
- 在aTSA中包括对比研究和评估LTO,SP和ST的案例系列.
- 对比研究进行的网络元分析,以综合证据.
主要成果:
- 审查中包括了23项研究.
- LTO和SP显示西安大略关节炎得分明显高于ST;美国肩膀和肘部协会得分没有差异.
- 与LTO相比, subscapularis皮表现出优越的外部旋转;其他技术对之间的外部旋转没有显著差异. 报告了骨结合 (LTO) 和肌愈合 (ST,SP) 的加权平均值.
结论:
- 与ST相比,LTO和SP与高结合和愈合率有关,可能会改善肩部功能和生活质量.
- 无论是LTO和SP都显示出相对于 subscapularis 切相比,在解剖学全肩关节整形术中更好的结果的趋势.
- 这些发现表明LTO和SP可能是TSA中 subscapularis管理的首选技术.
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