Tenodesis has higher functional outcome; tenotomy has shorter OR times in LHBT treatment .
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2015;3(24):27 PLoS One. 2015 Mar 18;10(3):e0121286Seven studies (3 randomized controlled trials; 4 cohort studies) were included in this meta-analysis comparing tenodesis and tenotomy in the management of patients with lesions of the long head of the biceps tendon. Meta-analysis was performed on Constant score, complications, satisfaction, and operative time. Qualitative assessment was undertaken for postoperative range of motion. Tenodesis demonstrated higher postoperative Constant scores and lower rates of cramp pain and Popeye deformity, while no significant differences were observed in satisfaction or range of motion. Operative time was significantly shorter for tenotomy.
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نعم = 1
غير مؤكد = 0.5
غير ذي صلة = 0
لا = 0
يقيّم تقييم معايير الإبلاغ الشفافية التي يبلغ بها المؤلفون عن الخصائص المنهجية والتجريبية للتجربة في المنشور. ينقسم التقييم إلى خمس فئات معروضة أدناه.
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Introduction
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Accessing Data
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Analysing Data
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Results
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Discussion
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
مؤشر الهشاشة هو أداة تساعد في تفسير النتائج المهمة، وتوفر مقياسًا لقوة النتيجة. ويمثل مؤشر الهشاشة عدد الأحداث المتتالية التي يجب إضافتها إلى نتيجة ثنائية التفرع لجعل النتيجة غير مهمة. يمثل الرقم الصغير نتيجة أضعف ويمثل الرقم الكبير نتيجة أقوى.
لماذا كانت هناك حاجة لهذه الدراسة الآن؟
Long head of the biceps tendon lesions are common, particularly as individuals age. Surgery is indicated if conservative treatment can not manage symptoms. Tenotomy or tenodesis may be performed and are typically successful, though both are associated with their own advantages and disadvantages. As such, surgeons are split between which should be performed, and whether one option is superior to the other.
ما هو سؤال البحث الرئيسي؟
Is there a significant difference in clinical or functional outcome between tenotomy and tenodesis in patients with long head of the biceps tendon (LHBT) lesions?
- Constant scores were significantly higher with tenodesis versus tenotomy (5 studies; MD 2.84 [95%CI 0.37, 5.31]; p=0.02).
- Qualitative assessment of range of motion from three studies was undertaken, with all reporting no significant difference between tenodesis and tenotomy groups.
- Tenodesis demonstrated significantly lower rates of cramp pain (4 studies; RR 0.51 [95%CI 0.26, 0.98]; p=0.04) and Popeye deformity (7 studies; RR 0.18 [ 95%CI 0.11, 0.30]; p<0.00001). Rate of satisfaction was similar between groups (4 studies; RR 1.00 [095%CI 0.92, 1.09]; p=0.94).
- Tenotomy demonstrated a significantly shorter operative time compared to tenodesis (3 studies; MD 10.54 [95%CI 8.96, 12.12]; p<0.00001).
ما الذي يجب أن أتذكره أكثر؟
Tenodesis demonstrated significantly higher postoperative Constant score and lower incidences of cramp pain and Popeye deformity compared to tenotomy in patients with long head of the biceps tendon lesions. Tenotomy took significantly less time to complete compared to tenodesis. Range of motion postoperative did not appear to significantly differ between tenodesis and tenotomy, and patients were generally satisfied with either surgical treatment.
كيف سيؤثر ذلك على رعاية مرضاي؟
The results of this meta-analysis suggest that despite having increased surgical time, tenodesis may have improved functional outcomes after surgery for lesions of the long head of the biceps tendon, and may also reduce the risk of associated painful cramping and Popeye deformity. Additional, randomized controlled trials should be considerd to further add to the body of evidence comparing these two methods of treatment.
تنويه
هذا المحتوى الموجود في هذه الصفحة هو لأغراض إعلامية فقط وليس الغرض منه أن يكون بديلاً عن المشورة الطبية المتخصصة أو التشخيص أو العلاج. إذا كنت بحاجة إلى علاج طبي، اطلب دائمًا مشورة طبيبك أو اذهب إلى أقرب قسم طوارئ إليك. الآراء والمعتقدات ووجهات النظر التي يعبر عنها الأفراد في المحتوى الموجود في هذه الصفحة لا تعكس آراء ومعتقدات ووجهات نظر أورثوإيفيدنس.
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