Subacromial impingement syndrome: a systematic review of arthroscopic versus open subacromial decompression

doi:10.3969/j.issn.2095-4344.2014.46.031

Abstract

Abstract:

BACKGROUND: It is still disputed about the treatment of subacromial impingement syndrome at present, arthroscopic subacromial decompression or open subacromial decompression.

OBJECTIVE: To assess the clinical therapeutic effects of arthroscopic subacromial decompression versus open subacromial decompression in the treatment of subacromial impingement syndrome.

METHODS: Controlled trials on arthroscopic subacromial decompression versus open acromioplasty in the treatment of subacromial impingement syndrome were collected in different databases through computer search. There was no limitation for language, randomized controlled trials or blinded studies. At last, the meta-analysis was conducted by using RevMan5.0 software.

RESULTS AND CONCLUSION: Four randomized controlled trials and six non-randomized controlled trials were included in this study, involving 583 patients with subacromial impingement syndrome. The results of meta-analysis prompted that as to the hospital inpatient days and time until return to work, the group of arthroscopic subacromial decompression was shorter than open subacromial decompression. However, as to the postoperative shoulder functional scores, the operative time, patient’s satisfaction, and the rate of excellent and good results of postoperative UCLAs, there were no significant statistical differences between two groups. Due to the certain limitations and deficiencies of the quantity and quality in the included trials, there must still need large-sample, multi-centered, high-quality randomized controlled trials to confirm these results.

中国组织工程研究杂志出版内容重点：组织构建；骨细胞；软骨细胞；细胞培养；成纤维细胞；血管内皮细胞；骨质疏松；组织工程

全文链接：

Key words: acromion, shoulder impingement syndrome, arthroscopes

CLC Number:

R318

Dong Yan, Zhang Ke-yuan, Sun Xue-bin, Li Gang, Nijiati Abulimiti, Liu Yang. Subacromial impingement syndrome: a systematic review of arthroscopic versus open subacromial decompression [J]. Chinese Journal of Tissue Engineering Research, 2014, 18(46): 7538-7544.

Figures/Tables 5

2.1 文献检索及纳入情况初步检索时共有424篇与肩峰下撞击综合征相关的文献，发表时间为1983至2013年。通过阅读文题、摘要或全文后，按照纳入标准挑选出12篇文献，进一步阅读全文后，发现其中2篇使用的为同一组临床资料，1篇为未提供相关数据的英文摘要，故均剔除。最终共纳入10篇文献[9-18]，病例数总计583例，均为英文文献。其中包含随机对照试验4篇，按Jadad标准评分(0-5分)，高质量4分1篇，低质量2分3篇；非随机对照试验6篇，按非随机对照试验质量评价标准与记分表(0-12分)，其中10分1篇、8分2篇、7分1篇、5分2篇。均为中高质量非随机对照研究。纳入研究的基线特征见表3。 2.2 Meta分析结果 2.2.1 住院天数 2篇文献报告了两组患者的住院天数[9，17]，总计215例患者，其中关节镜组101例，开放手术组114例。两个研究间异质性检验无统计学差异(I2=0%，P=0.57)，故采用固定效应模型进行Meta分析，结果显示两种手术方法的住院天数的差异有显著性意义[WMD= -0.50，95%CI(-0.56，-0.44)，P < 0.000 01]，表明关节镜组患者的平均住院天数比开放手术组少(图1)。 2.2.2 恢复工作时间 4篇文献报告了两组患者的恢复工作时间[9，10，16-17]，总计287例患者，其中关节镜组136例，开放手术组151例。各研究间异质性检验无统计学差异(I2=0%，P=0.45)，故采用固定效应模型进行Meta分析，结果显示两种手术方法治疗后恢复工作时间的差异有显著性意义[WMD=-7.10，95%CI(-9.17，-5.02)，P < 0.000 01]，表明关节镜组患者的平均恢复工作时间比开放手术组短(图2)。另有2篇文献仅提供了均数[12-13]，无其他相关数据，故无法纳入Meta分析，但所得结论与上述4篇文献一致，因而不影响Meta分析的结果(图2)。"

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