Effectiveness and safety of tenosynovitis of the long head of the biceps brachii with acupuncture: a protocol for a systematic review and meta-analysis

Abstract

Background Tenosynovitis of the long head of the biceps (LHB) brachii is a common disease in patients over 40 years old. It can always result in chronic anterior shoulder pain and limited function. Acupuncture is one of most popular conservative treatment methods, and increasing studies indicate that it has remarkable therapeutic effects on the tenosynovitis of LHB brachii. However, the effectiveness and safety of acupuncture for treating tenosynovitis of LHB brachii remain largely uncertain. In our study, we will perform the first systematic review and meta-analysis to explore the effectiveness and safety of acupuncture on the tenosynovitis of LHB brachii. Methods We will search the randomized controlled trial (RCT) literatures involving acupuncture for treating tenosynovitis of LHB brachii in eight electric databases, including PubMed, Web of Science, EMBASE, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wanfang Database, and Technology Periodical Database (VIP). We will define the visual analog scale (VAS), the Melle score of shoulder joint functional activity, and the ability assessment of daily living activities (ADL) as the primary outcomes. Besides quality of life, adverse events caused by acupuncture will be regarded as the secondary outcomes. Quality assessment of the included studies will be independently performed according to the Cochrane Risk of Bias tool. Meanwhile, the level of evidence for results will be assessed by using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) method. All analyses will be conducted by using the RevMan software V5.3. Results From the study, we will ascertain the effectiveness and safety of acupuncture treatment on tenosynovitis of LHB brachii. Conclusion The conclusion of this study will confirm the effectiveness and safety of acupuncture in the treatment of tenosynovitis of LHB brachii, which can provide new evidence to guide appropriate interventions on tenosynovitis of LHB brachii with acupuncture in the future. Ethics and dissemination Ethical approval is not required because no individual patient data are collected. This review will be published in a peer-reviewed journal and presented at an international academic conference for dissemination. Trial registration PROSPERO registration number CRD42020167434. Registered on April 28, 2020.

Treatment outcomes of tendinitis of long head of the biceps brachii tendon by different surgeries based on the concept of enhanced recovery after surgery

“…According to major studies, the incidence rate of shoulder deformity increases after LHBT tenotomy compared to that after tenodesis. [22][23][24] In a recent retrospective study by Godenèche et al, [25] during the 10-year follow-up, no deformity occurred at all after LHBT tenodesis or tenotomy. A total of 11.4% of patients undergoing tenodesis suffer from Popeye deformity, possibly as the biceps tendon has insufficient tension or the tendon is in a position where the biceps tendon…”

The Use of Evidence-Based Acupuncture: Current Evidence

“…A small sample size resulted in inconsistent and imprecise results [22]. Although the Cochrane systematic review (CSR) is regarded as the highest level of evidence, it cannot be ruled out that the CSR in acupuncture may have methodological flaws [53].…”