Anthony's North Hospital, Wesminster, CO, USA.
J Am Acad Orthop Surg. 2012 Nov;20(11):704-14. doi: 10.5435/JAAOS-20-11-704.
Degenerative joint disease following trauma to the elbow is difficult to manage in any patient. However, this condition becomes substantially more challenging in the young, active population. Increased activity demands and limited functional capacity of total elbow arthroplasty mean that joint arthroplasty should be regarded as a salvage procedure. The primary goal of treatment is to restore a pain-free or minimally painful functional joint while preserving future surgical options. This requires accurate assessment of the primary patient complaint, be it terminal pain and stiffness or pain along the entire arc of motion. Patients who report stiffness and pain at terminal motion may benefit from arthroscopic or open osteocapsular débridement. Those with advanced degenerative changes and pain throughout the entire arc of motion may require joint resurfacing with interposition arthroplasty, partial joint arthroplasty, or total joint arthroplasty.
创伤后肘关节退行性关节病在任何患者中都难以处理。然而,在年轻、活跃的人群中,这种情况变得更加具有挑战性。活动需求增加和全肘关节置换术的功能能力有限意味着关节置换术应被视为一种挽救性手术。治疗的主要目标是恢复无痛或轻度疼痛的功能关节,同时保留未来的手术选择。这需要准确评估主要患者的主诉,无论是终末疼痛和僵硬还是整个运动弧上的疼痛。报告终末运动时僵硬和疼痛的患者可能受益于关节镜或开放性骨膜清创术。那些有晚期退行性改变和整个运动弧疼痛的患者可能需要关节表面置换、部分关节置换或全关节置换来进行关节再成形。