The efficacy of SLAP repair and biceps tendon tenotomy and fixation for type Ⅱ SLAP lesions in shoulder arthroscopic:a Meta-analysis / 中华骨科杂志

ABSTRACT

Objective To evaluate the effects of SLAP repair and biceps tendon tenotomy and fixation in treating type Ⅱ superior labrum from anterior to posterior in shoulder arthroscopy.Methods PubMed,CNKI,VIP,and Wanfang database were searched electronically to screen randomized controlled trials and non randomized controlled trials that comparing two surgical methods for type Ⅱ SLAP lesions.In addition,we also retrieved the domestic orthopedic magazine and searches references that we had included in the present study.According to the criterion,screening literatures,data extraction and quality assessment were conducted by two reviewers independently.Meta-analysis was performed by using RevMan 5.3 software to evaluate UCLA scores,ASES scores,VAS scores and SST scores.Results A total of 7 articles were included in the present study,including 3 literatures in Chinese and 4 in English.There were 2 randomized controlled trials and 5 non randomized controlled trials.Two hundred and fifty-six patients were enrolled in the present study,including one hundred and twenty-five patients with SLAP repair and one hundred and thirty-one patients with biceps tendon tenotomy and fixation.Meta-analysis showed that there was significant difference in total score of UCLA [MD=2.55,95％CI(0.57,4.53),P=0.01] and shoulder function in the UCLA scoring system [MD=0.62,95％ CI(0.21,1.02),P=0.003] compared with SLAP repair.There was no difference in the UCLA scoring system,including pain [MD=0.99,95％CI(-0.15,2.14),P=0.09],flexion [MD=0.16,95％CI(0.01,0.32),P=0.06],strength [MD=0.03,95％CI(-0.15,0.22),P=0.74],satisfaction [SMD=0.18,95％ CI(-0.57,0.93),P=0.64] compared with SLAP repair.There was significant difference in ASES scores [MD=6.32,95％CI(2.55,10.08),P=0.001] between two groups.There was no difference in VAS scores [MD=0.54,95％CI (-0.64,1.72),P=0.37] and SST scores [MD=0.81,95％CI(-0.23,1.86),P=0.13] between two groups.Conclusion The UCLA scores,ASES scores and surgical results of biceps tendon tenotomy and fixation are superior to SLAP repair in treating type Ⅱ SLAP lesions.However,there is no significant advantage in pain,flexion,strength and satisfaction between the two groups.