More re-tears after single- compared to double-row rotator cuff repair .
This report has been verified
by one or more authors of the
original publication.
Questo studio è stato identificato come potenzialmente ad alto impatto.
La metrica High Impact di OE, guidata dall'AI, stima l'influenza che un articolo potrebbe avere integrando i segnali della rivista in cui è stato pubblicato e il contenuto scientifico dell'articolo stesso.
Sviluppato utilizzando un'elaborazione del linguaggio naturale all'avanguardia, il modello High Impact di OE prevede in modo più accurato la futura performance citazionale di uno studio rispetto al solo fattore di impatto della rivista.
Ciò consente di riconoscere prima le ricerche clinicamente significative e aiuta i lettori a concentrarsi sugli articoli che hanno maggiori probabilità di influenzare la pratica futura.
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2014;2(11):29 J Shoulder Elbow Surg. 2014 Apr;23(4):586-97. doi: 10.1016/j.jse.2013.10.006. Epub 2014 Jan 8Exclusive Author Interview
Dr. P.J. Millett discusses the rate of re-tears in single- as compared to double-row rotator cuff repair
7 level I randomized controlled trials comparing single- and double-row rotator cuff repair were included in this meta-analysis. The purpose of this review was to compare the clinical and structural outcomes associated with each treatment approach. Pooled data revealed that single- and double-row anchoring techniques yielded similar American Shoulder and Elbow Surgeons (ASES), the University of California - Los Angeles (UCLA), and Constant scores. Although there were no significant differences between groups with regard to the incidence of full-thickness re-tears, the number of partial-thickness re-tears was significantly higher after single-row repair.
Were the search methods used to find evidence (original research) on the primary question or questions stated?
Was the search for evidence reasonably comprehensive?
Were the criteria used for deciding which studies to include in the overview reported?
Was the bias in the selection of studies avoided?
Were the criteria used for assessing the validity of the included studies reported?
Was the validity of all of the studies referred to in the text assessed with use of appropriate criteria (either in selecting the studies for inclusion or in analyzing the studies that were cited)?
Were the methods used to combine the findings of the relevant studies (to reach a conclusion) reported?
Were the findings of the relevant studies combined appropriately relative to the primary question that the overview addresses?
Were the conclusions made by the author or authors supported by the data and or analysis reported in the overview?
How would you rate the scientific quality of this evidence?
Sì = 1
Incerto = 0,5
Non rilevante = 0
No = 0
La valutazione dei criteri di segnalazione valuta la trasparenza con cui gli autori riportano le caratteristiche metodologiche e sperimentali dello studio all'interno della pubblicazione. La valutazione è suddivisa in cinque categorie che vengono presentate di seguito.
4/4
Introduction
4/4
Accessing Data
4/4
Analysing Data
3/4
Results
3/4
Discussion
Detsky AS, Naylor CD, O'Rourke K, McGeer AJ, L'Abbé KA. J Clin Epidemiol. 1992;45:255-65
L'Indice di Fragilità è uno strumento che aiuta l'interpretazione dei risultati significativi, fornendo una misura della forza di un risultato. L'Indice di Fragilità rappresenta il numero di eventi consecutivi che devono essere aggiunti a un risultato dicotomico per rendere il risultato non più significativo. Un numero piccolo rappresenta un risultato più debole, mentre un numero grande rappresenta un risultato più forte.
Perché questo studio era necessario ora?
Arthroscopic rotator cuff repair can be performed using single- or double-row techniques. Biomechanical studies have found double-row repair to be superior, however conflicting evidence exists regarding the superiority of one technique over the other with respect to clinical and structural outcomes. As previous reviews have included Level II or III evidence, this study was needed to summarize only the evidence of the highest quality (i.e. level I evidence) on this topic.
Qual era la domanda di ricerca principale?
Is there any significant difference in clinical outcome or the incidence of re-tear between single- and double-row techniques in rotator cuff repair?.
- 7 randomized controlled trials (all Level I evidence) were included in this review. (Total patients=567; 285 single-row group and 282 double-row group)
- 3 studies reported the improvement between preoperative and postoperative ASES scores. Pooled data revealed no significant difference between single- and double-row repair for this outcome (WMD -2.1; 95% CI -7.3 to 3.2; p=0.440; I-squared: 0%).
- There was no significant difference between groups with respect to improvement in UCLA scores (3 studies; WMD 1.1; 95% CI -0.3 to 2.5; p=0.116; I-squared: 29%).
- Improvement in Constant scores was pooled in 3 studies. Meta-analysis of this outcome revealed no significant difference between groups for this outcome (WMD -3.7; 95% CI -8.8 to 1.4; p=0.156; I-squared: 0%).
- When all re-tears were considered (i.e. both full- and partial-thickness), the incidence was significantly higher with single-row repair (6 studies; RR 1.76; 95% CI 1.25 to 2.48; p=0.001; I-squared: 0%).
- The incidence of full-thickness re-tears was similar between single- and double-row repair (3 studies; RR 1.03; 95% CI 0.45 to 2.33; p=0.953; I-squared: 0%).
- The incidence of partial-thickness re-tears was significantly higher with single-row repair (3 studies; RR 1.99; 95% CI 1.04 to 3.82; p=0.039; I-squared: 41%).
Che cosa devo ricordare di più?
Arthroscopic rotator cuff repair using single- and double-row anchoring techniques yielded similar American Shoulder and Elbow Surgeons (ASES), the University of California - Los Angeles (UCLA), and Constant scores. Although there was no significant difference between groups in the incidence of full-thickness re-tears, the number of partial-thickness re-tears was significantly higher with single-row repair. When both types of re-tears were considered (i.e. full- and partial-thickness), results significantly favoured double-row repair.
Come influenzerà l'assistenza ai miei pazienti?
The results from this meta-analysis support the use of double-row rotator cuff repair as clinical outcomes were similar and re-tear rates were significantly lower (especially partial-thickness re-tears) when compared to single-row repair. However, additional high-quality studies are needed to confirm these findings.
DISCLAIMER
Il contenuto di questa pagina è solo a scopo informativo e non intende sostituire la consulenza, la diagnosi o il trattamento medico professionale. Se ha bisogno di cure mediche, si rivolga sempre al suo medico o al pronto soccorso più vicino. Le opinioni, le convinzioni e i punti di vista espressi dalle persone sui contenuti presenti in questa pagina non riflettono le opinioni, le convinzioni e i punti di vista di OrthoEvidence.
0 di 4 articoli mensili GRATUITI sbloccati
