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Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis
Introduction: Subscapularis tendon repair in reverse total shoulder arthroplasty represents a potentially modifiable risk factor for dislocation, and its role continues to be debated. The purpose of the present meta-analysis was to compare the outcomes of the primary lateralized RSAs with and withou...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307830/ https://www.ncbi.nlm.nih.gov/pubmed/34300180 http://dx.doi.org/10.3390/jcm10143014 |
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author | Corona, Katia Cerciello, Simone Ciolli, Gianluca Proietti, Lorenzo D’Ambrosi, Riccardo Braile, Adriano Toro, Giuseppe Romano, Alfonso Maria Ascione, Francesco |
author_facet | Corona, Katia Cerciello, Simone Ciolli, Gianluca Proietti, Lorenzo D’Ambrosi, Riccardo Braile, Adriano Toro, Giuseppe Romano, Alfonso Maria Ascione, Francesco |
author_sort | Corona, Katia |
collection | PubMed |
description | Introduction: Subscapularis tendon repair in reverse total shoulder arthroplasty represents a potentially modifiable risk factor for dislocation, and its role continues to be debated. The purpose of the present meta-analysis was to compare the outcomes of the primary lateralized RSAs with and without subscapularis repair in terms of range of motion, clinical outcomes, dislocations, and complications rate. Materials and Methods: A systematic literature search in MEDLINE (Pubmed), Embase, and the Cochrane Central Register of Controlled Trials database was carried up to December 2020. A data extraction form was developed to collect select data from the included studies. The methodological quality was assessed using a Methodological Index for Nonrandomized Studies (MINORS) score. Statistical analysis was performed with Review Manager (Version 5.4, The Cochrane Collaboration). Results: A total of four comparative studies involving 978 patients were included. In the pooled analysis, the reinsertion of the subscapularis yielded better functional outcomes in terms of the constant (P < 0.00001) and ASES (P = 0.002) scores. The forward elevation, external rotation at 0°, internal rotation, and dislocation rates were comparable between the two groups (P = n.s.), while statistically increased abduction was observed in those patients who did not have their subscapularis repaired (P < 0.00001). Conclusion: The results of the present findings suggest that it seems reasonable to reinsert the subscapularis whenever it is present, in good tissue conditions, and with no evidence of fatty degeneration of its muscle belly. Level of evidence: Level III meta-analysis |
format | Online Article Text |
id | pubmed-8307830 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-83078302021-07-25 Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis Corona, Katia Cerciello, Simone Ciolli, Gianluca Proietti, Lorenzo D’Ambrosi, Riccardo Braile, Adriano Toro, Giuseppe Romano, Alfonso Maria Ascione, Francesco J Clin Med Review Introduction: Subscapularis tendon repair in reverse total shoulder arthroplasty represents a potentially modifiable risk factor for dislocation, and its role continues to be debated. The purpose of the present meta-analysis was to compare the outcomes of the primary lateralized RSAs with and without subscapularis repair in terms of range of motion, clinical outcomes, dislocations, and complications rate. Materials and Methods: A systematic literature search in MEDLINE (Pubmed), Embase, and the Cochrane Central Register of Controlled Trials database was carried up to December 2020. A data extraction form was developed to collect select data from the included studies. The methodological quality was assessed using a Methodological Index for Nonrandomized Studies (MINORS) score. Statistical analysis was performed with Review Manager (Version 5.4, The Cochrane Collaboration). Results: A total of four comparative studies involving 978 patients were included. In the pooled analysis, the reinsertion of the subscapularis yielded better functional outcomes in terms of the constant (P < 0.00001) and ASES (P = 0.002) scores. The forward elevation, external rotation at 0°, internal rotation, and dislocation rates were comparable between the two groups (P = n.s.), while statistically increased abduction was observed in those patients who did not have their subscapularis repaired (P < 0.00001). Conclusion: The results of the present findings suggest that it seems reasonable to reinsert the subscapularis whenever it is present, in good tissue conditions, and with no evidence of fatty degeneration of its muscle belly. Level of evidence: Level III meta-analysis MDPI 2021-07-06 /pmc/articles/PMC8307830/ /pubmed/34300180 http://dx.doi.org/10.3390/jcm10143014 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Review Corona, Katia Cerciello, Simone Ciolli, Gianluca Proietti, Lorenzo D’Ambrosi, Riccardo Braile, Adriano Toro, Giuseppe Romano, Alfonso Maria Ascione, Francesco Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title | Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title_full | Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title_fullStr | Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title_full_unstemmed | Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title_short | Clinical Outcomes and Joint Stability after Lateralized Reverse Total Shoulder Arthroplasty with and without Subscapularis Repair: A Meta-Analysis |
title_sort | clinical outcomes and joint stability after lateralized reverse total shoulder arthroplasty with and without subscapularis repair: a meta-analysis |
topic | Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8307830/ https://www.ncbi.nlm.nih.gov/pubmed/34300180 http://dx.doi.org/10.3390/jcm10143014 |
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