中国组织工程研究 ›› 2014, Vol. 18 ›› Issue (17): 2777-2782.doi: 10.3969/j.issn.2095-4344.2014.17.026

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

关节镜肩袖修补后早期功能锻炼的Meta分析

沈  翀,唐志宏,胡军祖,邹国耀,肖荣驰,严冬雪,刘瑞端   

  1. 桂林医学院附属医院脊柱骨病外科,广西壮族自治区桂林市  541001
  • 修回日期:2014-01-06 出版日期:2014-04-23 发布日期:2014-04-23
  • 作者简介:沈翀,男,1980年生,广西壮族自治区桂林市人,汉族,2009年广西医科大学毕业,硕士,主治医师,主要从事骨关节疾病方面的研究。

Early functional exercises after arthroscopic rotator cuff repairs: a meta-analysis

Shen Chong, Tang Zhi-hong, Hu Jun-zu, Zou Guo-yao, Xiao Rong-chi, Yan Dong-xue, Liu Rui-duan   

  1. Department of Spine and Orthopedic Surgery, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China
  • Revised:2014-01-06 Online:2014-04-23 Published:2014-04-23
  • About author:Shen Chong, Master, Attending physician, Department of Spine and Orthopedic Surgery, Affiliated Hospital of Guilin Medical University, Guilin 541001, Guangxi Zhuang Autonomous Region, China

摘要:

背景:目前关节镜肩袖修补后延期功能锻炼是否能提高肌腱的愈合率尚不清楚。关于肩袖修补后的功能锻炼时机仍无定论,且无相关系统评价发表。
目的:系统评价关节镜肩袖修补后早期与延期功能锻炼的疗效差异。
方法:检索Pubmed, EMBASE,Cochrane对照实验中心注册数据库,以及中国生物医学文献数据库、万方数据库、清华同方数据库、重庆维普数据库。英文检索词为“arthroscopy,rotator cuff,rehabilitation”,中文检索词为“肩关节镜,肩袖,康复”。对入选文献的参考文献进行二次检索。检索截止日期为2012-08-15。要求纳入文献均为关节镜肩袖修补后早期与延期功能锻炼的随机对照研究,进行方法学质量评价、筛选和异质性检验,采用REVMAN5.1软件对提取的数据进行分析。
结果与结论:共纳入3个随机对照试验,共包括237例患者,119例为早期活动组,118例为延期活动组。分析显示2组在术后1年随访时关节活动度、疼痛程度、美国肩肘外科医生评分、简明肩关节功能测试评分、肩袖再撕裂率差异均无显著性意义。提示与延期功能锻炼相比,关节镜肩袖修补后早期功能锻炼在关节功能及活动度的改善方面并无优势,但也不增加修补肩袖的再撕裂率。肩袖修补后康复方案可根据患者的实际情况进行制定。


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


全文链接:

关键词: 植入物, 关节植入物, 肩关节镜, 肩袖, 肌腱, 康复, 系统评价

Abstract:

BACKGROUND: At present, it remains unclear whether delayed functional exercises after arthroscopic rotator cuff repairs could elevate the healing rate of tendon. The opportunity of functional exercises after rotator cuff repairs is still controversial, and there is no relevant system evaluation.
OBJECTIVE: To systematically evaluate the differences in curative effects of early and delayed functional exercises after arthroscopic rotator cuff repairs.
METHODS: We searched the Pubmed, EMBASE, Cochrane Central Register of Controlled Clinical Trials, Chinese Biomedical Literature Database, Wanfang Data, China National Knowledge Infrastructure, and Chongqing VIP Database. The key words were “arthroscopy, rotator cuff, rehabilitation”. The references of the included literatures were re-retrieved. The deadline of retrieval was August 15, 2012. The included literatures were randomized controlled trials on early and delayed functional exercises after arthroscopic rotator cuff repairs. Methodological quality evaluation, screening and heterogeneous test were conducted. REVMAN5.1 software was utilized to analyze the extracted data.
RESULTS AND CONCLUSION: We included three randomized controlled trials, including 237 patients: 119 in the early movement group and 118 in the delayed movement group. During follow-up at 1 year after operation, no significant differences in range of motion, pain degree, American Shoulder and Elbow Surgeons Scale, Simple Should Test scores and re-tear rate of rotator cuff were detected between the two groups. Results confirmed that compared with delayed functional exercises, early functional exercises after arthroscopic rotator cuff repair did not have advantages on the improvement of joint function and range of motion, but also did not negatively affect cuff healing. Postoperative rehabilitation can be modified to ensure patient’s compliance.


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


全文链接:

Key words: arthroscopes, meta-analysis, range of motion, articular, randomized controlled trial

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