Endoscopic decompression of the ulnar nerve in the cubital tunnel yields similar outcomes but a lower complication rate than open decompression: a systematic review and meta-analysis

2016 ◽  
Vol 2 (1) ◽  
pp. 8-13
Author(s):  
Kyle R Sochacki ◽  
Derek T Bernstein ◽  
Joshua D Harris ◽  
Shari R Liberman
Keyword(s):  
Systematic Review ◽  
Ulnar Nerve ◽  
Complication Rate ◽  
Meta Analysis ◽  
Cubital Tunnel ◽  
Endoscopic Decompression ◽  
Lower Complication ◽  
Lower Complication Rate

scholarly journals Clinical Outcomes of Interposition Graft Versus Superior Capsular Reconstruction in Patients With Irreparable Rotator Cuff Tears: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (9) ◽  
pp. 232596712110222
Author(s):  
Samuel Baek ◽  
Myung Ho Shin ◽  
Tae Min Kim ◽  
Je Min Im ◽  
Kyung-Soo Oh ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Complication Rate ◽  
Meta Analysis ◽  
Rotator Cuff Tears ◽  
Superior Capsular Reconstruction ◽  
Surgical Methods ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Retear Rate

Background: Interposition grafting (IG), also called bridging grafting, and superior capsular reconstruction (SCR) are the most commonly used joint-preserving surgical methods for irreparable rotator cuff tears (RCTs). Purpose: To compare the effectiveness of IG versus SCR to treat patients with irreparable RCTs. Study Design: Systematic review; Level of evidence, 4. Methods: A literature search was performed in MEDLINE, Embase, and Scopus. Included in this review were clinical studies evaluating the effect of IG or SCR in patients with irreparable RCTs with a minimum follow-up of 1 year. Various clinical results from the studies were extracted and compared between IG and SCR, and among them, the results of the American Shoulder and Elbow Surgeons score, graft retear rate, and complication rate were included in the meta-analysis. Results: Of 1638 identified articles, 17 (10 studies of IG involving 321 patients and 7 studies of SCR involving 357 patients) were selected. Both surgical methods showed significantly improved clinical outcomes in all but 1 study; however, the IG group had lower pain visual analog scale score, higher Constant score, and bigger active forward flexion and internal rotation compared with the SCR group (all P < .001). The meta-analysis showed no difference in the American Shoulder and Elbow Surgeons score between groups ( P = .44), but showed a significantly lower complication rate in the IG group compared with the SCR group (1.12% vs 8.37%, respectively; P < .001). The graft retear rate was not significantly different between groups (IG = 10.64% vs SCR = 12.67%; P = .79). The meta-analysis of graft type indicated no difference between groups in retear rate (autograft: 95% CI, 0.045-0.601; I2 = 93.28 [IG], 91.27 [SCR]; P = .22; allograft: 95% CI, 0.041-0.216; I2 = 80.39 [IG], 69.12 [SCR]; P = .64) or complication rate (autograft: 95% CI, 0.009-0.150; I2 = 0 [IG], 65.89 [SCR]; P = .25; allograft: 95% CI, 0.012-0.081; I2 = 0 [IG], 30.62 [SCR]; P = .09). Conclusion: Both IG and SCR techniques resulted in improvement in patients with irreparable RCTs. Meta-analysis showed a lower complication rate in the IG group; however, the lack of randomized studies limited our conclusions.

Arthroscopic superior capsular reconstruction versus latissimus dorsi transfer for irreparable rotator cuff lesions: a systematic review

2020 ◽  
Vol 134 (1) ◽  
pp. 85-96
Author(s):  
Leonardo Osti ◽  
Lorenzo Milani ◽  
Emanuele Gerace ◽  
Sara Padovani ◽  
Leo Massari ◽  
...  
Keyword(s):  
Systematic Review ◽  
Rotator Cuff ◽  
Complication Rate ◽  
Latissimus Dorsi ◽  
Latissimus Dorsi Transfer ◽  
Superior Capsular Reconstruction ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Rotator Cuff Lesions ◽  
Meta Analyses

Abstract Introduction The present systematic review compared arthroscopic superior capsular reconstruction (ASCR) and latissimus dorsi transfer (ALDT) for the management of massive irreparable rotator cuff lesions. Sources of data We performed a systematic review searching the literature on Medline, Cochrane and Scopus databases, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Areas of agreement We included a total of 20 articles, 10 on ASCR and 10 on ALDT (12 retrospective and 8 prospective studies), all published between 2013 and 2019. Areas of controversy ASCR and ALDT are technical demanding procedures. When compared to each other, they do not produce significantly different improvements in clinical outcome. Growing points Both ASCR and ALDT are valid options for surgical management of MIRCLs. Although ALDT has shown a greater complication rate and a less improvement in acromion-humeral distance, its clinical outcomes overlap those obtained with ASCR. Areas timely for developing research Further comparative prospective and retrospective studies with longer follow-up could confirm which surgical procedure can lead to better outcomes with a lower complication rate.

scholarly journals Effectiveness and Safety of Surgical Interventions for Treating Adolescent Idiopathic Scoliosis: a Bayesian Meta-analysis

2020 ◽  
Author(s):  
Long Chen ◽  
Zeyu Sun ◽  
Jingming He ◽  
Yunwen Xu ◽  
Zhuhai Li ◽  
...  
Keyword(s):  
Idiopathic Scoliosis ◽  
Pulmonary Function ◽  
Cobb Angle ◽  
Complication Rate ◽  
Meta Analysis ◽  
Secondary Outcome ◽  
Surgical Interventions ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Post Operation

Abstract BackgroundAdolescent idiopathic scoliosis (AIS) is the most common form of spinal deformity in children and adolescents which presents as complex three-dimensional (3D) deformity of the spine and rib cage. This study aimed to estimate the effectiveness and safety of surgical interventions for AIS using Bayesian meta-analysis. MethodsThe PubMed, EMBASE, and Cochrane Controlled Register of Trials were searched through Oct 1, 2019, without language restrictions. Relevant studies evaluating combined effectiveness and safety of surgical interventions for AIS were included according to eligibility criteria. The primary outcome measures included pulmonary function (change of absolute forced vital capacity and forced expiratory volume in one second from pre-operation to post-operation) and incidence of complications. The secondary outcome measure was change of Cobb angle from pre-operation to post-operation. Data was pooled using a random effects model in pairwise meta-analysis. Bayesian meta-analysis combined direct and indirect evidence using a Bayesian framework. Results28 case-controlled studies with totally 1970 participants were included. This Bayesian meta-analysis combining direct and indirect evidences indicated that posterior fusion with instrumentation without thoracoplasty (PSF) had the highest probability to achieve better pulmonary function and lower complication rate; video assisted anterior fusion with instrumentation without thoracoplasty (VAT) had the highest probability to obtain better Cobb angle correction based on analysis of rank probability. ConclusionThis Bayesian meta-analysis demonstrated that PSF had the highest probability to achieve better post-surgical pulmonary function and lower complication rate, which gives a practical recommendation of PSF as a primary surgical treatment for AIS. The results also support statistics that current surgeries adopted more PSF but less open anterior approach surgery and thoracoplasty. More research work is required to address the effectiveness and safety of VAT for treating AIS more convincingly.

scholarly journals Anterior Subcutaneous versus Submuscular Transposition of the Ulnar Nerve for Cubital Tunnel Syndrome: A Systematic Review and Meta-Analysis

PLoS ONE ◽  
2015 ◽  
Vol 10 (6) ◽  
pp. e0130843 ◽  
Author(s):  
Chun-Hua Liu ◽  
Chang-Xian Chen ◽  
Jie Xu ◽  
Han-Long Wang ◽  
Xiao-Bin Ke ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulnar Nerve ◽  
Meta Analysis ◽  
Cubital Tunnel Syndrome ◽  
Cubital Tunnel ◽  
Tunnel Syndrome

Modified Jobe Versus Docking Technique for Elbow Ulnar Collateral Ligament Reconstruction: A Systematic Review and Meta-analysis of Clinical Outcomes

2020 ◽  
Vol 49 (1) ◽  
pp. 236-248
Author(s):  
Austin M. Looney ◽  
David X. Wang ◽  
Christine M. Conroy ◽  
Jake E. Israel ◽  
Blake M. Bodendorfer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Ulnar Nerve ◽  
Systematic Reviews ◽  
Meta Analysis ◽  
Ulnar Collateral Ligament ◽  
Likelihood Method ◽  
Collateral Ligament ◽  
Ulnar Nerve Transposition ◽  
Significant Difference ◽  
Nerve Transposition

Background: The modified Jobe and docking techniques are the most common techniques used for elbow ulnar collateral ligament (UCL) reconstruction. Previous systematic reviews have suggested that the docking technique results in superior outcomes as compared with the Jobe (figure-of-8) technique. However, these included results from earlier studies in which the flexor-pronator mass (FPM) was detached and an obligatory submuscular ulnar nerve transposition was performed. Purpose/Hypothesis: The purpose was to compare the outcomes and return-to-play (RTP) time between the docking and figure-of-8 techniques for UCL reconstruction. We hypothesized that there would be no significant difference in the proportion of excellent outcomes between techniques when the FPM was preserved and no obligatory submuscular ulnar nerve transposition was performed. We also hypothesized that there would be no significant difference in RTP time between techniques. Study Design: Systematic review and meta-analysis. Methods: This study was performed in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. In the primary analysis, techniques were compared in random effects models by using the restricted maximum likelihood method, with weighted effect sizes calculated as the Freeman-Tukey double-arcsine transformed proportion of excellent outcomes for variance stabilization and with summary effects estimated from the inverse double-arcsine transformation per the harmonic mean of the sample sizes. Mean RTP times for techniques were compared in a separate model. Results: There were 21 eligible articles identified, with results for 1842 UCL reconstructions (n = 320, docking; n = 1466, figure-of-8). Without controlling for the effects of flexor-pronator detachment and submuscular ulnar nerve transposition, a significantly larger proportion of excellent outcomes was observed with docking reconstruction (86.58%; 95% CI, 80.42%-91.85%) than with figure-of-8 reconstruction (76.76%; 95% CI, 69.65%-83.25%; P = .031); however, there was no significant difference between techniques when controlling for FPM preservation or detachment with submuscular nerve transposition ( P = .139). There was no significant difference between techniques in time to return to sports ( P = .729), although no reconstructions with FPM detachment and submuscular ulnar nerve transposition were available for RTP time analysis. Conclusion: There was no significant difference in the proportion of excellent Conway Scale outcomes or RTP time between the docking and modified Jobe techniques for UCL reconstruction when the FPM was preserved and routine submuscular ulnar nerve transposition was not performed.

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