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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Guangdong Academy of Traditional Chinese Medicine, Research Team on Bone and Joint Degeneration and Injury, Guangzhou, China
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Rotator cuff tears are a common condition of the shoulder, and 20.7% of people with the condition have a full-thickness rotator cuff tear. The purpose of this study was to explore the risk factors for full-thickness rotator cuff tears and to provide evidence to support the accurate diagnosis of full-thickness rotator cuff tears.
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Studies from PubMed, Embase and Web of Science published before 30 January 2021 were retrieved. All cohort studies and cross-sectional studies on risk factors for full-thickness rotator cuff tears were included. A meta-analysis was performed in RevMan 5.3 to calculate the relative risks (RRs) or weighted mean differences (WMDs) of related risk factors. Stata 15.1 was used for the quantitative analysis of publication bias.
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In total, 11 articles from six countries, including 4047 cases, with 1518 cases and 2529 controls, were included. The meta-analysis showed that age (MD = 0.76, 95% CI: 0.24 to 1.28, P = 0.004), hypertension (RR = 1.46, 95% CI: 1.17 to 1.81, P = 0.0007) and critical shoulder angle (CSA) (MD = 2.02, 95% CI: 1.55 to 2.48, P < 0.00001) were risk factors for full-thickness rotator cuff tears.
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Our results also suggested that body mass index, sex, dominant hand, smoking, diabetes mellitus and thyroid disease were not risk factors for full-thickness rotator cuff tears. Early identification of risk factors for full-thickness rotator cuff tears is helpful in identifying high-risk patients and choosing the appropriate treatment.
Cite this article: EFORT Open Rev 2021;6:1087-1096. DOI: 10.1302/2058-5241.6.210027
Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Bone and Joint Research Team of Degeneration and Injury, Guangdong Provincial Academy of Chinese Medical Sciences, Guangzhou, China
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Guangdong Second Traditional Chinese Medicine Hospital (Guangdong Province Engineering Technology Research Institute of Traditional Chinese Medicine), Guangzhou, China
The fifth Clinical Medical College of Guangzhou University of Chinese Medicine, Guangzhou, China
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Purpose
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Considering the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids for treating osteoarthritis (OA), development of drugs that are more effective and better tolerated than existing treatments is urgently needed. This systematic review aimed to evaluate the efficacy and safety of anti-nerve growth factor (NGF) monoclonal antibodies vs active comparator therapy, such as NSAIDs and oxycodone, in treating hip or knee OA.
Methods
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Databases were comprehensively searched for randomized controlled trials (RCTs) published before January 2022. Efficacy and safety outcomes were assessed.
Results
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Six RCTs that included 4325 patients were identified. Almost all the RCTs indicated that moderate doses of anti-NGF monoclonal antibody treatment significantly improved efficacy outcomes based on the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain score, the WOMAC physical function score and the Patient’s Global Assessment compared with those of the active comparator. At least half of the RCTs indicated that the incidence of severe adverse events, withdrawals due to adverse events (AEs) and total joint replacement were not significantly different between anti-NGF monoclonal antibody treatment and active comparator therapy, but the outcomes of some studies may have been limited by a short duration of follow-up. Most RCTs suggested that anti-NGF monoclonal antibody treatment had a lower incidence of gastrointestinal and cardiovascular AEs. However, the majority of RCTs reported a higher incidence of abnormal peripheral sensation with anti-NGF monoclonal antibody treatment. Furthermore, the higher incidence of rapidly progressive osteoarthritis (RPOA) with anti-NGF monoclonal antibody treatment should also not be overlooked, and the identification of patient characteristics that increase the risk of RPOA is critical in further studies.
Conclusion
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Based on the current research evidence, anti-NGF monoclonal antibodies are not yet a replacement for analgesic drugs such as NSAIDs but might be a new treatment option for hip or knee OA patients who are intolerant or unresponsive to nonopioid or opioid treatment. Notably, however, considering the inconsistency and inconclusive evidence on the safety outcomes of recent studies, more research is needed, and long-term follow-up is required.
