SHOULDER & ELBOW
Clinical and structural outcomes after arthroscopic single-row versus double-row rotator cuff repair: a systematic review and meta-analysis of level I randomized clinical trials
This report has been verified
by one or more authors of the
original publication.
この研究はハイインパクトの可能性があります。
OEのAI駆動型ハイインパクト指標は、論文が掲載されたジャーナルと論文自体の科学的内容の両方からのシグナルを統合することで、論文が持つ可能性の高い影響力を推定します。
最先端の自然言語処理を用いて開発されたOEハイインパクトモデルは、ジャーナルのインパクトファクターのみよりも、研究の将来の引用実績をより正確に予測します。
これにより、臨床的に意義のある研究をより早く認識することが可能になり、読者は将来の診療を形成する可能性が最も高い論文に集中することができます。
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?
はい = 1
不確実＝0.5
無関係 = 0
いいえ = 0
報告基準評価では、著者が出版物内で試験の方法論的特徴や試験特性を報告する際の透明性を評価します。評価は以下の5つのカテゴリーに分類されます。
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
Fragility Indexは、重要な所見の解釈を助けるツールで、結果の強さの尺度を提供します。Fragility Indexは、その所見が有意でなくなるために、二項対立の結果に追加する必要がある連続した事象の数を表します。数値が小さいほど弱い所見を表し、数値が大きいほど強い所見を表します。
なぜ今この研究が必要なのですか？
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.
主な研究課題は何ですか？
Is there any significant difference in clinical outcome or the incidence of re-tear between single- and double-row techniques in rotator cuff repair?.
重要な知見は？
- 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%).
最も覚えておくべきことは？
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.
それが私の患者ケアにどのように影響するか？
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.
免責事項
このページに記載されている内容は、情報提供のみを目的としたものであり、専門的な医療アドバイス、診断、治療の代わりとなるものではありません。治療が必要な場合は、必ず医師の診断を仰ぐか、最寄りの救急外来を受診してください。このページに記載されている内容に関して個人が表明した意見、信念、見解は、OrthoEvidenceの意見、信念、見解を反映するものではありません。
0の4 月間無料記事のロック解除
