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肱骨外上髁炎关节镜治疗的长期随访

Long-term follow-up of arthroscopic treatment of lateral epicondylitis.

作者信息

Baker Champ L, Baker Champ L

机构信息

The Hughston Clinic, PC, 6262 Veterans Parkway, Columbus, GA 31909, USA.

出版信息

Am J Sports Med. 2008 Feb;36(2):254-60. doi: 10.1177/0363546507311599.

Abstract

BACKGROUND

In a previously published report of the authors' arthroscopic technique of operative management of recalcitrant lateral epicondylitis, they demonstrated short-term success with the procedure in their patients.

HYPOTHESIS

Arthroscopic management of patients with lateral epicondylitis can produce clinical improvement and have successful long-term outcomes.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

Forty patients (42 elbows) with lateral epicondylitis who had not responded to nonoperative management were treated with arthroscopic resection of pathologic tissue. Thirty of these patients (30 elbows) were located for extended follow-up. At a mean follow-up of 130 months (range, 106-173 months), patients were asked to use a numeric scale to rate their elbow pain from 0 (no pain) to 10 (severe pain). Patients were also asked to rate their elbows according to the functional portion of the Mayo Clinic Elbow Performance Index.

RESULTS

The mean pain score at rest was 0; with activities of daily living, 1.0; and with work or sports, 1.9. The mean functional score was 11.7 out of a possible 12 points. No patient required further surgery or repeat injections after surgery. One patient continued to wear a counterforce brace with heavy activities. Twenty-three patients (77%) stated they were "much better," 6 patients (20%) stated they were "better," and 1 patient (3%) stated he was the same. Twenty-six patients (87%) were satisfied, and 28 patients (93%) stated they would have the surgery again if needed.

CONCLUSION

Arthroscopic removal of pathologic tendinosis tissue is a reliable treatment for recalcitrant lateral epicondylitis. The early high rate of success in patients was maintained at long-term follow-up.

摘要

背景

在作者先前发表的关于顽固性外侧上髁炎手术治疗的关节镜技术报告中,他们展示了该手术在患者中的短期成功。

假设

关节镜治疗外侧上髁炎患者可产生临床改善并获得成功的长期结果。

研究设计

病例系列;证据等级,4级。

方法

40例(42个肘关节)外侧上髁炎患者,经非手术治疗无效后接受关节镜下病理组织切除术。其中30例患者(30个肘关节)接受了延长随访。平均随访130个月(范围106 - 173个月),患者被要求使用数字评分量表对其肘部疼痛进行评分,从0(无疼痛)到10(剧痛)。患者还被要求根据梅奥诊所肘关节功能指数的功能部分对其肘部进行评分。

结果

静息时平均疼痛评分为0;日常生活活动时为1.0;工作或运动时为1.9。平均功能评分为11.7分(满分12分)。术后无患者需要进一步手术或重复注射。1例患者在进行剧烈活动时继续佩戴反作用力支具。23例患者(77%)表示“好多了”,6例患者(20%)表示“有所好转”,1例患者(3%)表示情况相同。26例患者(87%)表示满意,28例患者(93%)表示如有需要愿意再次接受手术。

结论

关节镜下切除病理性肌腱病组织是治疗顽固性外侧上髁炎的可靠方法。患者早期的高成功率在长期随访中得以维持。

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