腱固定与盂唇修复治疗肩关节SLAP损伤的系统评价和序贯分析

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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.

Received: 28 March 2021

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