关节镜手术联合富血小板血浆修复肩袖撕裂的Meta分析

Arthroscopic surgery combined with platelet-rich plasma to repair rotator cuff tear(a Meta-analysis)

目的通过Meta分析比较关节镜手术联合富血小板血浆与单纯关节镜手术修复肩袖撕裂的疗效。方法检索自2010-01—2018-12收录在PubMed、Medline、Cochrane等数据库关于比较关节镜手术联合富血小板血浆(观察组)与单纯关节镜手术(对照组)修复肩袖撕裂疗效的相关文献,采用RevMan 5.3软件进行Meta分析,比较2组术后DASH评分、UCLA评分、SST评分、ASES评分、Constant评分及肩袖再次撕裂发生率。结果纳入10篇文献,共598例,观察组320例,对照组278例。观察组与对照组术后6、12个月DASH评分差异无统计学意义(P>0.05);观察组术后6、12个月UCLA评分较对照组高,术后12个月SST评分较对照组高,术后6个月ASES评分较对照组高,术后肩袖再次撕裂发生率较对照组低,差异有统计学意义(P <0.05);观察组术后6、12个月Constant评分较对照组高(P <0.05),但术后24个月2组Constant评分比较差异无统计学意义(P>0.05)。结论关节镜手术联合富血小板血浆修复肩袖撕裂可以改善患者术后早期肩关节功能,降低术后肩袖再次撕裂的发生率,但是对于术后远期肩关节功能没有更明显的改善作用。

Objective To compare the clinical effect of arthroscopic surgery combined with platelet-rich plasma and arthroscopic surgery alone in repairing rotator cuff tears with the Meta-analysis.Methods The articles on the comparison of arthroscopic surgery combined with platelet-rich plasma(observation group)and arthroscopic surgery(control group)to repair rotator cuff tears in PubMed,Medline,Cochrane and other databases from January 2010 to December 2018 were retrieved.RevMan 5.3 software was used for Meta-analysis to compare the postoperative DASH score,UCLA score,SST score,ASES score,Constant scale score,and rotator cuff recurrence rate between the observation group and the control group.Results A total of 598 cases were included in 10 articles,with 320 cases in the observation group and 278 cases in the control group.Meta-analysis results showed that there was no significant difference in DASH scores between 6 and 12 months after operation in the two groups(P>0.05).The UCLA scores in the observation group were higher than those in the control group at 6 and 12 months after surgery,the SST scores in the observation group were higher than those in control group at 12 months after surgery,and the ASES score in the observation group was higher than that of the control group at 6 months after operation.The rotator cuff tear rate of the observation group was lower than that of the control group after surgery.The difference was statistically significant(P<0.05).The Constant scale score at 6,12 months after surgery of the observation group was higher than that of the control group(P<0.05),but there was no significant difference in the Constant scale score between the two groups 24 months after surgery(P>0.05).Conclusion Arthroscopic surgery combined with platelet-rich plasma to repair rotator cuff tears can improve early shoulder function and reduce the incidence of rotator cuff tears after surgery,but there is no significant improvement in long-term shoulder function.