Biceps tenodesis versus labral repair for surgical treatment of isolated SLAP lesions: a meta-analysis and trial sequential analysis
ZHANG Peng1,2, LI Chunbao3, ZHANG Baiqing2,3, WANG Wenliang1, LIU Yujie3
1. Department of Sports Medicine, Characteristic Medical Center of Chinese People's Armed Police Force, Tianjin 300162, China; 2. Chinese PLA Medical School,Beijing 100853,China; 3. Department of Orthopedics Surgery, Fourth Medical Center of Chinese PLA General Hospital, Beijing 100853, China
Abstract：Objective To evaluate the efficacy and possible risks of biceps tenodesis (BT) and labral repair (LR) in the treatment of isolated SLAP lesions.Methods PubMed, Embase, CNKI, WanFang Data, VIP Database, Web of Science and Cochrane Library were searched for related literature that was published from inception to October 19, 2020. The studies selected were screened according to the predefined inclusion and exclusion criteria. Meta-analysis was performed using Stata 14, while TSA 0.9.5.10 Beta software was used for trial sequential analysis.Results Seven studies involving 279 patients were included,with 148 in the LR group and 131 in the BT group. The results of meta-analysis showed that the patients' level of satisfaction (OR=0.29,95%CI:0.11-0.76) and the number of patients who resumed activity (OR=0.32,95%CI:0.15-0.71) in the BT group were significantly higher than those of the LR group. There was no significant difference in the American Shoulder and Elbow Surgeons score (WMD=-0.34,95% CI:-9.59-2.79), the University of California at Los Angeles score (WMD=-1.94,95%CI:-5.58-1.70), visual analogue scale (WMD=-0.73,95%CI:-2.01-0.54), the incidence of complications (OR=1.71,95% CI:0.56-5.22) or the rate of reoperations (OR=0.98,95% CI: 0.33-2.90) between the two groups. Sequential analysis of the trial showed that the cumulative level of patient satisfaction crossed the traditional boundary and that of trial sequential analysis, which confirmed the clinical efficacy of BT in improving patient satisfaction. However, the cumulative number of patients who resumed activity crossed the traditional boundary rather than the trial sequence monitoring boundary, suggesting that the evidence was insufficient and inconclusive.Conclusions BT can improve postoperative satisfaction levels of patients more significantly than LR,and proves to be quite safe with no high incidence of complications or reoperations. However, more high-quality randomized controlled trials need to be included for further verification.
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2021, Vol. 32 
