Soojian Michael G, Kwon Young W
NYU Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, New York 10003, USA.
Bull NYU Hosp Jt Dis. 2007;65(1):61-71.
Patients with elbow arthritis typically present with complaints of pain and stiffness. Rheumatoid arthritis is the most common cause of elbow arthritis, followed by posttraumatic arthritis and primary osteoarthritis. Nonoperative management consisting of oral analgesics, intra-articular steroid injections, physical therapy, and splinting may provide symptomatic relief in the majority of patients. If these modalities fail, operative treatment is guided by the severity of disease as well as several patient-related factors such as age, activity level, and expectations. Total elbow arthroplasty can provide satisfactory results in the majority of patients with significant degeneration of the elbow. However, due to issues regarding prosthesis longevity, this procedure is generally avoided in young active patients. Other operative treatment options for such patients include arthroscopic or open synovectomy, debridement arthroplasty, and interpositional arthroplasty. As all of these operations may provide a satisfactory outcome for the appropriate patient, a thorough preoperative evaluation is essential in choosing the suitable surgical procedure for each individual patient.
肘部关节炎患者通常表现为疼痛和僵硬。类风湿性关节炎是肘部关节炎最常见的病因,其次是创伤后关节炎和原发性骨关节炎。非手术治疗包括口服镇痛药、关节内注射类固醇、物理治疗和夹板固定,大多数患者可通过这些方法获得症状缓解。如果这些方法无效,手术治疗则根据疾病的严重程度以及一些与患者相关的因素,如年龄、活动水平和期望来进行。全肘关节置换术能为大多数肘部严重退变的患者提供满意的效果。然而,由于假体使用寿命的问题,年轻活跃的患者一般不采用这种手术。这类患者的其他手术治疗选择包括关节镜或开放滑膜切除术、清创关节成形术和间置关节成形术。由于所有这些手术都可能为合适的患者带来满意的结果,因此术前进行全面评估对于为每个患者选择合适的手术方式至关重要。