Operative Versus Non-Operative Treatment of Distal Biceps Ruptures: A Systematic Review and Meta-Analysis

2022 ◽  
Author(s):  
Austin M. Looney ◽  
Jonathan Day ◽  
Blake M. Bodendorfer ◽  
David Wang ◽  
Caroline M. Fryar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Meta Analysis ◽  
Distal Biceps

scholarly journals Treatment of Pectoralis Major Tendon Tears: A Systematic Review and Meta-Analysis of Operative and Nonoperative Treatment

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0041
Author(s):  
Blake Bodendorfer ◽  
Brian McCormick ◽  
David Wang ◽  
Christine Conroy ◽  
Caroline Fryar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Mixed Model ◽  
Meta Analysis ◽  
Random Effect ◽  
Nonoperative Treatment ◽  
Pectoralis Major ◽  
Isokinetic Strength ◽  
Tendon Tears

Objectives: The incidence of pectoralis major tendon tears is rising, and repair is generally considered, but there is a paucity of comparative data to demonstrate the superiority of operative treatment. We sought to compare the outcomes of operative and nonoperative treatment of pectoralis major tendon tears. We hypothesized that repair would result in superior outcomes compared to nonoperative treatment. Methods: In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic review of the literature was completed using MEDLINE, SPORTDiscus, CINAHL, Cochrane, Embase and Web of Science databases. English-language studies were included with a minimum of 6 months average follow-up and 5 cases per study. Methodological Index for Nonrandomized Studies was utilized to assess the quality of the existing literature. Meta-analysis of pooled mechanisms of injury and outcomes was completed. Pooled effect-sizes were calculated from random effects models. Continuous variables were assessed using mixed model analysis with the individual study designated as a random effect and the desired treatment for comparison as a fixed effect. Bivariate frequency data was transformed using the Freeman-Tukey log-linear transformation for variance stabilization and then assessed using a mixed model with a study-level random effect and subsequently back-transformed. Significance was set at P<.05. Results: Twenty-three articles with 664 injuries met the inclusion criteria for comparison (Figure 1). All patients were male with 63.2% of injuries occurring during weight training, with an average age of 31.48 years and follow-up of 37.02 months. Included studies had moderately high methodological quality. Operative treatment was significantly superior to nonoperative treatment with a relative improvement of functional outcome by 0.70 (P=.027), full isometric strength by 77.07% (P<.001), isokinetic strength by 28.86% (P<.001) compared to the uninjured arm, cosmesis satisfaction by 13.79% (P=.037), and resting deformity by 98.85% (P<.001) (Table 1). There was an overall complication rate of 14.21%, including a 3.08% rate of rerupture, for operative treatment. Conclusion: Pectoralis major tendon repair resulted in significantly superior outcomes as compared to nonoperative treatment with an associated 14.21% complication rate. There was a statistically significant improvement in functional outcome, isokinetic strength, isometric strength, cosmesis, and resting deformity. [Figure: see text][Table: see text]

scholarly journals Change in Impairment following Operative Treatment of Degenerative Cervical Myelopathy: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 6 (1_suppl) ◽  
pp. s-0036-1583088-s-0036-1583088
Author(s):  
Mohammed Shamji ◽  
Lindsay Tetreault ◽  
Shekar Kurpad ◽  
Darrel Brodke ◽  
Justin Smith ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Cervical Myelopathy ◽  
Meta Analysis ◽  
Degenerative Cervical Myelopathy

scholarly journals Operative Treatment of Isolated Meniscus Injuries in Adolescent Patients: A Meta-Analysis and Review

2018 ◽  
Vol 10 (4) ◽  
pp. 311-316 ◽  
Author(s):  
Gina M. Mosich ◽  
Virginia Lieu ◽  
Edward Ebramzadeh ◽  
Jennifer J. Beck
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Meta Analysis ◽  
Meniscus Repair ◽  
Meniscal Tears ◽  
Level Of Evidence ◽  
Adolescent Population ◽  
Meniscus Tears ◽  
Adolescent Patients

Context: With the rise in sports participation and increased athleticism in the adolescent population, there is an ever-growing need to better understand adolescent meniscus pathology and treatment. Objective: To better understand the operative management of meniscus tears in the adolescent population. Data Sources: A systematic review of PubMed (MEDLINE) and Google Scholar was performed for all archived years. Study Selection: Studies that reported on isolated meniscus tears in adolescent patients (age, 10-19 years) were included. Study Design: Systematic review and meta-analysis. Level of Evidence: Level 4. Data Extraction: Two authors reviewed and extracted data from studies that fulfilled all inclusion criteria. Results: Nine studies on isolated meniscus tears in adolescent patients were found, with level of evidence ranging from 3 to 4. These studies evaluated a total of 373 patients (248 males, 125 females) and 390 knees. Seven studies were published between 1979 and 2000, all of which discuss meniscectomy as the primary treatment. Two studies were published after 2000 and report on meniscus repair surgery. The mean patient age was 14.4 years. A total of 308 meniscectomies and 64 meniscus repairs were performed. Follow-up ranged from 1.8 to 30 years (mean, 10.8 years). A 37% retear rate was reported for patients undergoing meniscus repair. Different outcome measures were used for meniscectomy versus meniscus repair. Three studies evaluating meniscectomy reported Tapper-Hoover scores, showing 54 patients with an excellent result, 58 with good, 57 with fair, and 23 with poor results. Conclusion: A shift in the management of isolated adolescent meniscal tears is reflected in the literature, with a recent increase in operative repair. This is likely secondary to poor outcomes after meniscectomy reflected in long-term follow-up studies. The current literature highlights the need for improved description of tear patterns, standardized reporting of outcome measures, and improved study methodologies to help guide orthopaedic surgeons on operative treatment of meniscal tears in adolescent patients.

Differences in risk factors exist for the occurrence of bilateral versus unilateral distal biceps tendon ruptures: a systematic review

2020 ◽  
pp. jisakos-2020-000570
Author(s):  
Christina Barrett Hawkins ◽  
Rebecca Abromitis ◽  
Carola van Eck
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Biceps Tendon ◽  
Meta Analysis ◽  
Distal Biceps Tendon ◽  
Level Of Evidence ◽  
Distal Biceps ◽  
Biceps Rupture ◽  
Tendon Ruptures ◽  
Distal Biceps Rupture

ImportanceDistal biceps rupture is a debilitating injury that is increasing in incidence. A subset of patient experiences this injury on both sides, simultaneously or at separated times. Previous studies have evaluated the incidence and risk factors of unilateral distal biceps rupture. However, little is known about the risk factors for bilateral distal biceps rupture.AimsThis aims of this study were to determine risk factors for bilateral distal biceps rupture and to compare these to the known risk factors for unilateral rupture.Evidence reviewA systematic review of literature was conducted using five databases, producing a total of 1183 papers. After the review process, 31 papers with data bilateral distal biceps tendon ruptures were included.FindingsThe 31 papers included a total of 2234 patients with 2366 ruptures. Patients with a bilateral rupture were younger than patients with unilateral ruptures (45.8 vs 48.8 years old). Women made up a larger percentage of patients with bilateral ruptures (6.8% vs 4.0%). Bilateral injuries occurred most commonly during heavy lifting or falls, whereas forced extension of the arm was the most frequently reported injury mechanism reported with unilateral ruptures. Tobacco used was more common in patients with bilateral ruptures (24.4% vs 6.8%). Labour-intensive occupations and anabolic steroid use did not appear to increase the risk of a bilateral rupture. Pooling of the data was not possible due to heterogeneity of the included studies.ConclusionsWhile differences in risk factors between patients with unilateral and bilateral ruptures were observed, there was too great of a degree of heterogeneity among the studies to perform a meta-analysis of the data.Level of evidenceSystematic review; level III evidence.

scholarly journals Treatment of Pectoralis Major Tendon Tears: A Systematic Review and Meta-analysis of Operative and Nonoperative Treatment

2020 ◽  
Vol 8 (2) ◽  
pp. 232596711990081
Author(s):  
Blake M. Bodendorfer ◽  
Brian P. McCormick ◽  
David X. Wang ◽  
Austin M. Looney ◽  
Christine M. Conroy ◽  
...  
Keyword(s):  
Systematic Review ◽  
Operative Treatment ◽  
Mixed Model ◽  
Meta Analysis ◽  
Random Effect ◽  
Nonoperative Treatment ◽  
Pectoralis Major ◽  
Isokinetic Strength ◽  
Tendon Tears

Background: The incidence of pectoralis major tendon tears is increasing, and repair is generally considered; however, a paucity of comparative data are available to demonstrate the superiority of operative treatment. Purpose/Hypothesis: The purpose of this study is to compare the outcomes of operative and nonoperative treatment of pectoralis major tendon tears. We hypothesized that repair would result in superior outcomes compared with nonoperative treatment. Methods: In accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, a systematic review of the literature was completed by use of MEDLINE, SPORTDiscus, CINAHL, Cochrane, EMBASE, and Web of Science databases. We included English-language studies that had a minimum of 6 months of average follow-up and 5 cases per study. The MINORS (Methodological Index for Non-Randomized Studies) was used to assess the quality of the existing literature. Meta-analysis of pooled mechanisms of injury and outcomes was completed. Pooled effect sizes were calculated from random-effects models. Continuous variables were assessed by use of mixed-model analysis, with the individual study designated as a random effect and the desired treatment for comparison as a fixed effect. Bivariate frequency data were transformed via the Freeman-Tukey log-linear transformation for variance stabilization and then assessed through use of a mixed model with a study level random effect and subsequently back-transformed. Significance was set at P < .05. Results: A total of 23 articles with 664 injuries met the inclusion criteria for comparison. All patients were male, with an average age of 31.48 years; 63.2% of injuries occurred during weight training, and the average follow-up was 37.02 months. Included studies had moderately high methodological quality. Operative treatment was significantly superior to nonoperative treatment, with relative improvements of functional outcome by 23.33% (0.70 improvement by Bak criteria which is scored 1-4; P = .027), full isometric strength 77.07% ( P < .001), isokinetic strength 28.86% ( P < .001) compared with the uninjured arm, cosmesis satisfaction 13.79% ( P = .037), and resting deformity 98.85% ( P < .001). The overall complication rate for operative treatment was 14.21%, including a 3.08% rate of rerupture. Conclusion: Pectoralis major tendon repair resulted in significantly superior outcomes compared with nonoperative treatment, with an associated 14.21% complication rate. Statistically significant improvements were noted in functional outcome, isokinetic strength, isometric strength, cosmesis, and resting deformity.

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