Long head of biceps tendon transposition for massive and irreparable rotator cuff tears:A systematic review and meta-analysis  

作　　者：Ren-Wen Wan Zhi-Wen Luo Yi-Meng Yang Han-Li Zhang Jia-Ni Chen Shi-Yi Chen Xi-Liang Shang 

机构地区：[1]Department of Sports Medicine,Huashan Hospital,Fudan University,Shanghai 200040,China

出　　处：《World Journal of Orthopedics》2023年第11期813-826,共14页世界骨科杂志（英文版）

基　　金：the National Natural Science Foundation of China,No.81972125 and No.82172510.

摘　　要：BACKGROUND Superior capsular reconstruction(SCR)with long head of biceps tendon(LHBT)transposition was developed to massive and irreparable rotator cuff tears(MIRCTs);however,the outcomes of this technique remain unclear.AIM To perform a systematic review of biomechanical outcomes and a meta-analysis of clinical outcomes after LHBT transposition for MIRCTs.METHODS We performed a systematic electronic database search on PubMed,EMBASE,and Cochrane Library.Studies of SCR with LHBT transposition were included according to the inclusion and exclusion criteria.Biomechanical studies were assessed for main results and conclusions.Included clinical studies were evaluated for quality of methodology.Data including study characteristics,cohort demographics,and outcomes were extracted.A meta-analysis was conducted of the clinical outcomes.RESULTS According to our inclusion and exclusion criteria,a total of six biomechanical studies were identified and reported an overall improvement in subacromial contact pressures and prevention of superior humeral migration without limiting range of motion(ROM)after LHBT transposition for MIRCTs.A total of five clinical studies were included in the meta-analysis of LHBT transposition outcomes,consisting of 253 patients.The results indicated that compared to other surgical methods for MIRCTs,LHBT transposition had advantages of more significant improvement in ROM(forward flexion mean difference[MD]=6.54,95%confidence interval[CI]:3.07-10.01;external rotation[MD=5.15,95%CI:1.59-8.17];the acromiohumeral distance[AHD][MD=0.90,95%CI:0.21-1.59])and reducing retear rate(odds ratio=0.27,95%CI:0.15-0.48).No significant difference in American Shoulder and Elbow Surgeons score,visual analogue scale score,and University of California at Los Angles score was demonstrated between these two groups for MIRCTs.CONCLUSION In general,SCR with LHBT transposition was a reliable and economical technique for treating MIRCTs,both in terms of biomechanical and clinical outcomes,with comparable clinical outcomes,imp

关 键 词：Massive and irreparable rotator cuff tears Long head of biceps tendon transposition Rotator cuff repair Superior capsular reconstruction 

分 类 号：R687.2[医药卫生—骨科学]