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首页> 外文期刊>Orthopaedic Journal of Sports Medicine >Variability of Reporting Recurrence After Arthroscopic Bankart Repair: A Call for a Standardized Study Design
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Variability of Reporting Recurrence After Arthroscopic Bankart Repair: A Call for a Standardized Study Design

机译：关节镜Bankart修复后报告复发的变异性：要求标准化研究设计

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Background: High recurrence rates have been reported after anterior shoulder dislocations, regardless of the treatment utilized. However, the definition of recurrent instability has been inconsistent, making a comparison between studies difficult. Purpose: To report on the nature with which the rate of recurrent instability is reported after arthroscopic Bankart repair, across all levels of evidence, and to analyze factors that may affect the reported rate of recurrence. Study Design: Systematic review; Level of evidence, 4. Methods: A systematic review of the literature was performed by searching PubMed, the Cochrane Central Register of Controlled Trials, Embase, and ClinicalTrials.gov for studies published within the dates of January 2008 and September 2018. Studies in English that reported on the recurrence of instability after arthroscopic Bankart repair for anterior shoulder instability were considered for inclusion in this review. A meta-regression was performed to test for a linear association between the reported recurrence rate and several continuous covariates, including mean age at surgery, mean length of follow-up, attrition rate (loss to follow-up percentage), and percentage of male patients. Results: A trim-and-fill meta-analysis yielded an estimated overall recurrence rate of 17.4% (95% CI, 14.3%-20.9%). There was a significant difference in the recurrence rate depending on the level of evidence (Q(3) = 10.98; P = .012). Significant associations were found with the recurrence rate through the meta-regression, including a negative association with mean age ( P = .009), a positive association with mean follow-up time ( P = .002), and a positive association with attrition rate ( P = .035). Conclusion: A call for standardization is necessary for reporting outcomes of anterior instability after arthroscopic Bankart repair, especially with regard to the reporting of recurrence/failure rates, with careful consideration of the effects that may occur from patient demographics and study design. With no current recommendations for deeming failure, we suggest that all forms of instability be accounted for when determining a failed treatment procedure, with future studies placing an emphasis on greater control of the study design.
机译：背景：前肩脱位后，无论采用何种治疗方法，均已报告高复发率。但是，复发性不稳定的定义一直不一致，因此很难进行研究之间的比较。目的：在所有级别的证据中，报告在关节镜行Bankart修复后报告复发不稳定率的性质，并分析可能影响所报告的复发率的因素。研究设计：系统评价;证据等级，4。方法：通过搜索PubMed，Cochrane对照试验中心注册，Embase和ClinicalTrials.gov对文献进行系统的综述，以研究2008年1月至2018年9月之间发表的研究。这篇报道报道了关节镜Bankart修复前肩不稳后复发不稳的报道。进行了荟萃回归，以检验报告的复发率与几个连续协变量之间的线性关系，包括手术时的平均年龄，平均随访时间，损耗率（失访率）和男性百分比耐心。结果：修剪和填充荟萃分析估计总体复发率为17.4％（95％CI，14.3％-20.9％）。根据证据水平，复发率存在显着差异（Q（3）= 10.98; P = .012）。通过荟萃回归发现与复发率显着相关，包括与平均年龄的负相关（P = .009），与平均随访时间的正相关（P = .002）和与损耗的正相关。率（P = .035）。结论：要求标准化是报告关节镜Bankart修复后前路不稳的结果的必要条件，特别是在报告复发/失败率方面，要仔细考虑患者人口统计学和研究设计可能产生的影响。由于目前尚无认为失败的建议，我们建议在确定失败的治疗程序时应考虑所有形式的不稳定性，未来的研究将重点放在更好地控制研究设计上。

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