Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis
| Autor: | Francesco Ascione, Giuseppe Toro, Adriano Braile, Gianluca Ciolli, Katia Corona, Alfonso Maria Romano, Simone Cerciello, Riccardo D’Ambrosi, Lorenzo Proietti |
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| Přispěvatelé: | Corona, Katia, Cerciello, Simone, Ciolli, Gianluca, Proietti, Lorenzo, D'Ambrosi, Riccardo, Braile, Adriano, Toro, Giuseppe, Romano, Alfonso Maria, Ascione, Francesco |
| Rok vydání: | 2021 |
| Předmět: |
subscapularis repair
medicine.medical_specialty medicine.medical_treatment MEDLINE Joint stability Review 03 medical and health sciences 0302 clinical medicine Dislo-cation Settore MED/33 - Malattie Apparato Locomotore medicine Risk factor 030222 orthopedics dislocation business.industry 030229 sport sciences General Medicine Evidence-based medicine lateralized reverse shoulder arthroplasty Arthroplasty clinical outcomes Clinical outcomes Complication rates Lateralized reverse shoulder arthroplasty Meta-analysis Subscapularis repair meta-analysis Data extraction Physical therapy Medicine business Range of motion complication rates |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 3014, p 3014 (2021) Journal of Clinical Medicine |
| Popis: | Introduction: Subscapularis tendon repair in reverse total shoulder arthroplasty represents a potentially modifiable risk factor for dislocation, and its role continues to be debated. The purpose of the present meta-analysis was to compare the outcomes of the primary lateralized RSAs with and without subscapularis repair in terms of range of motion, clinical outcomes, dislocations, and complications rate. Materials and Methods: A systematic literature search in MEDLINE (Pubmed), Embase, and the Cochrane Central Register of Controlled Trials database was carried up to December 2020. A data extraction form was developed to collect select data from the included studies. The methodological quality was assessed using a Methodological Index for Nonrandomized Studies (MINORS) score. Statistical analysis was performed with Review Manager (Version 5.4, The Cochrane Collaboration). Results: A total of four comparative studies involving 978 patients were included. In the pooled analysis, the reinsertion of the subscapularis yielded better functional outcomes in terms of the constant (P < 0.00001) and ASES (P = 0.002) scores. The forward elevation, external rotation at 0°, internal rotation, and dislocation rates were comparable between the two groups (P = n.s.), while statistically increased abduction was observed in those patients who did not have their subscapularis repaired (P < 0.00001). Conclusion: The results of the present findings suggest that it seems reasonable to reinsert the subscapularis whenever it is present, in good tissue conditions, and with no evidence of fatty degeneration of its muscle belly. Level of evidence: Level III meta-analysis |
| Databáze: | OpenAIRE |
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