SHOULDER & ELBOW
No advantages in repairing a type II superior labrum anterior and posterior (SLAP) lesion when associated with rotator cuff repair in patients over age 50: A randomized controlled trial
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。
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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. 2013;1(2):141 Am J Sports Med. 2008 Feb;36(2):247-5363 patients, over the age of 50, suffering from both rotator cuff injuries and type II SLAP lesions were randomized to undergo repair of both injuries or only the rotator cuff repair. Results, following a minimum follow-up of 2.9 years, indicated that patients who underwent repair of only the rotator cuff had significantly better UCLA scores and ROM.
Was the allocation sequence adequately generated?
Was allocation adequately concealed?
Blinding Treatment Providers: Was knowledge of the allocated interventions adequately prevented?
Blinding Outcome Assessors: Was knowledge of the allocated interventions adequately prevented?
Blinding Patients: Was knowledge of the allocated interventions adequately prevented?
Was loss to follow-up (missing outcome data) infrequent?
Are reports of the study free of suggestion of selective outcome reporting?
Were outcomes objective, patient-important and assessed in a manner to limit bias (ie. duplicate assessors, Independent assessors)?
Was the sample size sufficiently large to assure a balance of prognosis and sufficiently large number of outcome events?
Was investigator expertise/experience with both treatment and control techniques likely the same (ie.were criteria for surgeon participation/expertise provided)?
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。
3/4
Randomization
3/4
Outcome Measurements
4/4
Inclusion / Exclusion
4/4
Therapy Description
3/4
Statistics
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？
There is a lack of quality research in the literature examining the results of type II SLAP lesion and rotator cuff repair in comparison to just rotator cuff repair, in patients suffering from both injuries. The only studies examining these differing repair methods were conducted in a youthful population, making it a necessity to assess these methods in an older population through this study.
主な研究課題は何ですか？
Is there a difference in clinical outcomes when comparing the repair of either rotator cuff and SLAP lesions or the repair of rotator cuff tears without the repair of the slap lesion in patients over the age of 50?
重要な知見は？
- None of the study subjects experienced infection or neurologic/vascular complications.
- Mean operative time was 90 SD 22.5 minutes in group 1 and 60 SD 16.4 minutes in group 2.
- In Group 1 (SLAP repair and rotator cuff repair), the UCLA score significantly improved from preoperative average rating of 10.4 (range, 6-14) to an average of 27.9 (range, 24-35), postoperatively (P < .001).
- In group 2 (biceps tenotomy and rotator cuff repair), the UCLA significantly improved from a preoperative average rating of 10.1 (range, 5-14) to an average of 32.1 (range, 30-35), postoperatively (P <.001)
- No statistically significant differences were found in total postoperative UCLA scores and range of motion in 2 groups postoperatively (P < .05).
最も覚えておくべきことは？
There were no advantages to repairing Type II SLAP lesions while repairing rotator cuff injuries compared to repairing rotator cuff on its own, in patients over the age of 50, as both had similar significant improved UCLA scores and ROM.
それが私の患者ケアにどのように影響するか？
Patients over the age of 50 presenting with rotator cuff tears and SLAP lesions should only undergo repair of the rotator cuff tear for optimal functional outcomes. Other studies to improve the surgical procedures should be undertaken.
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