Network Meta-Analysis Of Arthroscopic Repair Of Rotator Cuff Tears

Network Meta-analysis is a statistical method that combines multiple independent research results for quantitative and combined analysis,which overcomes the shortcomings of traditional meta-analysis that can only compare the efficacy of two therapeutic measures and has the powerful function of combining direct and indirect comparisons of multiple therapeutic measures.Through data analysis and statistical inference,Network Meta-analysis can enable doctors or patients to choose the safest and most influential of many treatment measures,thereby providing an accurate reference for clinical decision-making.In this study,a Network Meta-analysis of the repair efficacy of rotator cuff tears was carried out using frequency methods and Bayesian methods,including single-row repair,double-row repair,suture bridge repair,and PRPassisted repair and bone marrow stimulation techniques.The evaluation indexes in the analysis process include ASES score,Constant score,VAS score,UCLA score,and re-tear risk.The studies published before August 2021 in Pub Med,EMBASE,the Cochrane Library,and Web of Science databases,literature screening,and data extraction were carried out according to randomized controlled trials’ standards,and the Network Meta-analysis of frequency method was carried out.To compensate for the small amount of data,the Network Meta-analysis was re-performed after the inclusion of the cohort study was added in Chapter 4.The results obtained were compared with the analysis of randomized controlled trials.After comparison,it was found that the results of the reticular Meta-analysis obtained from the two inclusion criteria were essentially the same,which also indicated that the randomized controlled trials had higher confidence in the results despite their more minor number.The newly included cohort studies play a positive complementary role in the analysis.In Chapter 5,this paper conducts a Bayesian method-based Network Meta-Analysis of the data after adding the cohort study and compares the results of applying the random-effects model and the fixed-effects model,respectively.The results show that the random-effects model is more suitable for the Network Meta-analysis in the case of more extensive data volume and more complex data sources.At the same time,the efficacy ranking of each treatment measure obtained by the Bayesian method is roughly the same as that obtained by the frequency method,which shows that PRP-assisted repair,bone marrow stimulation technology,and double-row repair have good postoperative efficacy.This paper explores the efficacy of five rotator cuff repair techniques based on Network Meta-analysis and compares and verifies various methods.In addition,most of the published Meta-analyses on the repair of rotator cuff tears are traditional Meta-analyses,which lack a comprehensive comparison of various repair techniques.Therefore,the research results of this paper have specific clinical guiding significance.