Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies
Background: Total shoulder arthroplasty has been effective in treating primary glenohumeral arthritis surgically. However, the subscapularis (SSC) tendon must be released as part of the surgery's conventional approach, which could lead to postoperative problems and later tendon failure. Using a...
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| Format: | Article |
| Language: | English |
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Elsevier
2023-05-01
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| Series: | JSES Reviews, Reports, and Techniques |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639123000093 |
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| author | Mohammad Daher, BSc Ali Ghoul, MD Mohamad Y. Fares, MD Joseph Abboud, MD Bassem El Hassan, MD |
| author_facet | Mohammad Daher, BSc Ali Ghoul, MD Mohamad Y. Fares, MD Joseph Abboud, MD Bassem El Hassan, MD |
| author_sort | Mohammad Daher, BSc |
| collection | DOAJ |
| description | Background: Total shoulder arthroplasty has been effective in treating primary glenohumeral arthritis surgically. However, the subscapularis (SSC) tendon must be released as part of the surgery's conventional approach, which could lead to postoperative problems and later tendon failure. Using a procedure that spares the tendon, Lafosse et al reported improved postoperative SSC performance. This meta-analysis will compare this approach to the standard one. Methods: PubMed, Cochrane, and Google Scholar (pages 1-20) were searched till October 2022. The clinical outcomes consisted of the postoperative pain, adverse events, and range of motion. Results: Only 3 studies were included in this meta-analysis. The subscapularis sparing approach tended to have better postoperative internal rotation (P = .06) and shoulder elevation (P = .1); however, the results were marginally statistically insignificant. Conclusion: This is the first meta-analysis to compare the subscapularis sparing to the standard approach in total shoulder arthroplasty. Showing better postoperative range of motion (elevation and internal rotation), the SSC approach might be considered as a good substitute to the standard one. However, it is limited by the potentially limited exposure making it harder to use in muscular and obese patients. More randomized clinical trials are needed to reach more significant results and establish clearer indications of this approach. |
| first_indexed | 2024-04-09T15:30:14Z |
| format | Article |
| id | doaj.art-7f1e92e7f3bc4e26a93a9f7db903b1c5 |
| institution | Directory Open Access Journal |
| issn | 2666-6391 |
| language | English |
| last_indexed | 2024-04-09T15:30:14Z |
| publishDate | 2023-05-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj.art-7f1e92e7f3bc4e26a93a9f7db903b1c52023-04-28T08:56:37ZengElsevierJSES Reviews, Reports, and Techniques2666-63912023-05-0132160165Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studiesMohammad Daher, BSc0Ali Ghoul, MD1Mohamad Y. Fares, MD2Joseph Abboud, MD3Bassem El Hassan, MD4Hôtel Dieu de France, Orthopedic Department, Beirut, LebanonHôtel Dieu de France, Orthopedic Department, Beirut, LebanonRothman Institute/Thomas Jefferson Medical Center, Philadelphia, PA, USARothman Institute/Thomas Jefferson Medical Center, Philadelphia, PA, USAMassachusetts General Hospital, Orthopedic Department, Boston, MA, USA; Corresponding author: Bassem el Hassan, MD, Department of Orthopedics, Harvard University, 55 Fruit Street, Boston, MA 02114, USA.Background: Total shoulder arthroplasty has been effective in treating primary glenohumeral arthritis surgically. However, the subscapularis (SSC) tendon must be released as part of the surgery's conventional approach, which could lead to postoperative problems and later tendon failure. Using a procedure that spares the tendon, Lafosse et al reported improved postoperative SSC performance. This meta-analysis will compare this approach to the standard one. Methods: PubMed, Cochrane, and Google Scholar (pages 1-20) were searched till October 2022. The clinical outcomes consisted of the postoperative pain, adverse events, and range of motion. Results: Only 3 studies were included in this meta-analysis. The subscapularis sparing approach tended to have better postoperative internal rotation (P = .06) and shoulder elevation (P = .1); however, the results were marginally statistically insignificant. Conclusion: This is the first meta-analysis to compare the subscapularis sparing to the standard approach in total shoulder arthroplasty. Showing better postoperative range of motion (elevation and internal rotation), the SSC approach might be considered as a good substitute to the standard one. However, it is limited by the potentially limited exposure making it harder to use in muscular and obese patients. More randomized clinical trials are needed to reach more significant results and establish clearer indications of this approach.http://www.sciencedirect.com/science/article/pii/S2666639123000093Subscapularis sparingTotal shoulder arthroplastyReverse shoulder arthroplastyStandard approachLimited exposurePostoperative range of motion |
| spellingShingle | Mohammad Daher, BSc Ali Ghoul, MD Mohamad Y. Fares, MD Joseph Abboud, MD Bassem El Hassan, MD Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies JSES Reviews, Reports, and Techniques Subscapularis sparing Total shoulder arthroplasty Reverse shoulder arthroplasty Standard approach Limited exposure Postoperative range of motion |
| title | Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies |
| title_full | Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies |
| title_fullStr | Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies |
| title_full_unstemmed | Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies |
| title_short | Subscapular sparing approach for total shoulder arthroplasty: a systematic review and meta-analysis of comparative studies |
| title_sort | subscapular sparing approach for total shoulder arthroplasty a systematic review and meta analysis of comparative studies |
| topic | Subscapularis sparing Total shoulder arthroplasty Reverse shoulder arthroplasty Standard approach Limited exposure Postoperative range of motion |
| url | http://www.sciencedirect.com/science/article/pii/S2666639123000093 |
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