中国组织工程研究

中国组织工程研究 ›› 2021, Vol. 25 ›› Issue (21): 3431-3437.doi: 10.3969/j.issn.2095-4344.3872

• 骨与关节循证医学 evidence-based medicine of the bone and joint • 上一篇    下一篇

关节镜下双排缝合固定与缝线桥固定修复肩袖损伤疗效对比的Meta分析

姜灵凯，魏  垒，董政权，顾晓东，李鹏翠   

  1. 山西医科大学第二医院骨科实验室，山西省太原市   030000
  • 收稿日期:2020-09-23 修回日期:2020-09-25 接受日期:2020-10-30 出版日期:2021-07-28 发布日期:2021-01-25
  • 通讯作者: 李鹏翠，博士，主任医师，山西医科大学第二医院骨科实验室，山西省太原市 030000
  • 作者简介:姜灵凯，男，1996年生，山西省人，山西医科大学在读硕士，主要从事骨与软组织修复研究。
  • 基金资助:
    国家自然科学基金面上项目(81772415)，项目负责人；魏垒

Comparison of the effects of arthroscopic double-row suture fixation and suture bridge fixation for rotator cuff injury: a meta-analysis 

Jiang Lingkai, Wei Lei, Dong Zhengquan, Gu Xiaodong, Li Pengcui   

  1. Laboratory of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
  • Received:2020-09-23 Revised:2020-09-25 Accepted:2020-10-30 Online:2021-07-28 Published:2021-01-25
  • Contact: Li Pengcui, MD, Chief physician, Laboratory of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
  • About author:Jiang Lingkai, Master candidate, Laboratory of Orthopedics, Second Hospital of Shanxi Medical University, Taiyuan 030000, Shanxi Province, China
  • Supported by:
    the National Natural Science Foundation of China, No. 81772415 (to WL) 

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摘要：

文题释义：
肩袖：是由冈上肌、冈下肌、肩胛下肌和小圆肌的肌腱在肱骨头前、上、后方形成的袖套样肌样结构。
缝合桥技术的优势：可减少锚钉的过多置入，增加肌腱与骨的接触面积和紧密度，从而促进肩袖的快速愈合。

目的：缝合桥固定技术是一种全新的肩袖修复技术。然而，关于双排固定技术与缝线桥技术的临床结果报道却存在较大差异。文章探究在肩袖损伤修复治疗中，应用关节镜下双排缝合固定与缝线桥固定技术的临床价值。
方法：运用计算机检索2010年7月至2020年7月PubMed、Web of Science、Embase、中国知网、万方数据库和中国生物医学系统，搜索关于比较关节镜下双排缝合固定与缝线桥固定技术修复肩袖损伤疗效的文献。采用Cochrane手册评估随机对照试验的质量，采用NOS量表评估队列研究的质量。提取出各研究中的数据并整理为表格，并将该研究数据利用RevMan 5.3软件进行Meta分析与综合。
结果：①共10篇文献，735例患者纳入分析，其中1篇文献为随机对照试验，9篇为回顾性队列研究，文献质量评估提示纳入文献质量较高；②Meta分析结果显示：与双排缝合固定技术相比，缝线桥技术在术后Constant评分(MD=1.11，95%CI：0.12-2.09，P=0.03)、术后目测类比评分(MD=-0.20，95%CI：-0.35至0.19，P=0.000 2)、术后再撕裂率(OR=0.28，95%CI：0.14-0.55，P=0.000 2)和手术时间(MD=-14.0，95%CI：-20.54至-7.47，P < 0.000 1)方面占优势，而在术后美国加州大学(UCLA)肩关节评分、美国肩肘外科协会(ASES)评分和术后活动度方面无显著差异。
结论：关节镜下缝线桥技术修复肩袖损伤可能较双排缝合固定具有更好的肩关节功能稳定性、更高的应用安全性与较轻的疼痛感，但仍需要更多的前瞻性、大样本随机对照试验提供一级证据来验证。
https://orcid.org/0000-0003-1298-138X (姜灵凯) 

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

关键词: 骨, 内固定, 关节镜, 双排缝合固定, 缝线桥技术, 肩袖损伤, 修复, Meta分析

Abstract: OBJECTIVE: Suture bridge fixation technology is a new rotator cuff repair technology. However, there is a big difference between the results of double row suture and clinical technique. This study explored the clinical value of arthroscopic double row suture fixation and suture bridge fixation in the repair of rotator cuff injury.
METHODS: A computer was used to search PubMed, Web of Science, Embase, CNKI, Wanfang, and China Biomedical System databases for articles on arthroscopic double row suture fixation and suture bridge fixation in the repair of rotator cuff injury published from July 2010 to July 2020. The Cochrane manual was used to assess the quality of randomized controlled trials, and the NOS scale was used to assess the quality of cohort studies. The data in each study were extracted and organized into tables. RevMan 5.3 software was used for meta-analysis and synthesis of the study data.
RESULTS: (1) A total of 10 articles and 735 patients were included in the analysis, of which one article was a randomized controlled trial and nine articles were a retrospective cohort study. The literature quality assessment indicated that the included literature was of high quality. (2)  Meta-analysis results showed that compared with the double row suture fixation technique, the suture bridge technique had advantages at Constant score (MD=1.11, 95%CI:0.12-2.09, P=0.03), postoperative visual analogue scale score (MD=-0.20, 95%CI:-0.35 to 0.19, P=0.000 2), postoperative tearing rate (OR=0.28, 95%CI:0.14-0.55, P=0.000 2), and operation time (MD=-14.0, 95%CI:-20.54 to -7.47, P < 0.000 1). There was no significant difference in postoperative University of California, Los Angeles score, postoperative rating scale of the American shoulder and elbow surgeons score, and postoperative range of motion.
CONCLUSION: The arthroscopic suture bridge technique may have better shoulder function stability, higher application safety and less pain than double row suture fixation. More prospective, large-sample randomized controlled studies are still needed to provide first-level evidence to verify.

Key words: bone, internal fixation, arthroscopy, double-row suture fixation, suture bridge technique, rotator cuff injury, repair, meta-analysis

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