The influence of sex is a neglected focus in rotator cuff repair: A systematic review and meta-analysis.

Autor: Monteleone AS; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland., Salerno M; Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy., Mondini Trissino da Lodi C; Neurocenter of Southern Switzerland, Regional Hospital of Lugano, Lugano, Switzerland., Gonalba GC; Scuola Specializzata Superiore in Cure Infermieristiche, Bellinzona, Switzerland., Candrian C; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland., Filardo G; Service of Orthopaedics and Traumatology, Department of Surgery, EOC, Lugano, Switzerland.; Applied and Translational Research Center, IRCCS Istituto Ortopedico Rizzoli, Bologna, Italy.; Faculty of Biomedical Sciences, Università della Svizzera Italiana, Lugano, Switzerland.
Jazyk: angličtina
Zdroj: Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA [Knee Surg Sports Traumatol Arthrosc] 2024 Oct; Vol. 32 (10), pp. 2699-2710. Date of Electronic Publication: 2024 Apr 28.
DOI: 10.1002/ksa.12201
Abstrakt: Purpose: Rotator cuff (RC) disorders are the most common cause of shoulder disability. The aim of this study was to quantify the evidence on the sex-related differences in RC repair.
Methods: A systematic review of the literature was performed in January 2023 in PubMed, Wiley Cochrane Library and Web of Science on research articles on humans with RC tears treated surgically. A meta-analysis was performed to compare results in men and women. The Downs and Black score and the modified Coleman methodology score (MCMS) were used to assess the retrieved studies.
Results: A total of 39,909 patients were enroled in the 401 studies analysed (45% women, 55% men). A trend toward more sex-balanced recruitment was observed over time. Only 4% of the studies on 1.5% of the documented patients presented disaggregated outcome data and were quantitatively analysed. A tendency for lower range of motion values after surgery was found for external shoulder rotation in women, with 39.9° ± 6.9° versus 45.3° ± 4.1° in men (p = 0.066). According to Downs and Black scores, four studies were good and 12 fair, with a main MCMS score of 69/100.
Conclusion: There is a lack of awareness on the importance to document women- and men-specific data. Only 4% of the articles disaggregated data, and it was possible to analyse only 1.5% of the literature population, a sample which cannot be considered representative of all patients. The lack of disaggregated data is alarming and calls for action to better study men and women differences to optimise the management of RC tears. This will be necessary to provide sex-specific information that could be of clinical relevance when managing RC repair.
Level of Evidence: Level IV.
(© 2024 The Authors. Knee Surgery, Sports Traumatology, Arthroscopy published by John Wiley & Sons Ltd on behalf of European Society of Sports Traumatology, Knee Surgery and Arthroscopy.)
Databáze: MEDLINE
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