Yan Hui, Cui Guo-Qing, Liu Yu-Lei, Xiao Jian, Yang Yu-Ping, Ao Ying-Fang
Institute of Sports Medicine, Peking University, Third Hospital, Beijing, China.
Zhonghua Wai Ke Za Zhi. 2009 Jun 15;47(12):888-91.
To compare open and arthroscopic methods for treatment of recalcitrant lateral epicondylitis.
A prospective trial of 26 patients (28 elbows) with recalcitrant lateral epicondylitis were treated between May 2006 and September 2008. The mean duration of conservative care was 23. 0 months (4 - 60 months). The mean follow-up was 17.4 months (4 - 32 months). The patients were randomized divided into two groups, 13 elbows with an open Nirschl procedure and 15 with an arthroscopic Nirschl procedure. All patients had pre- and post-operative assessment using VAS (visual analog scale) scores, Mayo 12 points elbow scores, time of return to work or sports, satisfaction, and so on.
There were no significant differences in VAS scores at rest and activities of daily living, time of return to work or sports and satisfaction between the two groups. But there was a statistically significant difference in VAS scores at work and sports and Mayo 12 points elbow scores between the two groups. 100% of the patients had excellent or good results in the open group and 93.3% in arthroscopic group. There were no severe complications in this series.
Both open and arthroscopic Nirschl procedures are valid and reliable treatments for patients with refractory lateral epicondylitis. The patients in the open group have a better function in the return-to work and sports postoperatively than the arthroscopic group.
比较开放手术和关节镜手术治疗顽固性外侧上髁炎的效果。
对2006年5月至2008年9月间收治的26例（28个肘关节）顽固性外侧上髁炎患者进行前瞻性试验。保守治疗的平均时长为23.0个月（4 - 60个月）。平均随访时间为17.4个月（4 - 32个月）。患者被随机分为两组，13个肘关节接受开放性Nirschl手术，15个接受关节镜下Nirschl手术。所有患者在术前和术后均使用视觉模拟评分（VAS）、梅奥12分肘关节评分、恢复工作或运动的时间、满意度等进行评估。
两组在静息及日常生活活动时的VAS评分、恢复工作或运动的时间以及满意度方面无显著差异。但两组在工作及运动时的VAS评分和梅奥12分肘关节评分存在统计学显著差异。开放手术组100%的患者结果为优或良，关节镜手术组为93.3%。本系列中无严重并发症。
开放性和关节镜下Nirschl手术都是治疗难治性外侧上髁炎患者的有效且可靠的方法。开放手术组患者术后在恢复工作和运动方面的功能比关节镜手术组更好。
