Cha Soo-Min, Shin Hyun-Dae, Kim Kyung-Cheon, Park Il-Young
Department of Orthopaedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
Department of Orthopaedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Chungnam National University Hospital, Chungnam National University School of Medicine, Daejeon, Korea.
J Hand Surg Am. 2014 Feb;39(2):209-18. doi: 10.1016/j.jhsa.2013.10.016. Epub 2013 Dec 18.
To compare the clinical and radiological outcomes in patients treated with the mini-open Outerbridge-Kashiwagi procedure according to radiological grading of the radiocapitellar joint.
Sixty-three patients with primary elbow arthritis diagnosed between March 2004 and February 2010 were enrolled. Patients without and with radiocapitellar arthrosis were assigned to groups 1 (n = 34) and 2 (n = 29), respectively. The mean follow-up period was 51 months. Clinical outcomes were compared between groups using the presence of resting elbow pain; Morrey pain score; the Mayo Elbow Performance Score; the Disabilities of the Arm, Shoulder and Hand score; and active range of motion. Radiological outcomes, including the presence of loose bodies and re-ossification of fenestration, were evaluated.
No patient in group 1 and 4 patients in group 2 reported resting elbow pain at the final follow-up examination. All pain was on the radial side, and it was aggravated in 2 patients. The Mayo Elbow Performance Score and Disabilities of the Arm, Shoulder and Hand score and active motion improved in both groups. No significant difference in the Morrey pain score, Mayo Elbow Performance Score, Disabilities of the Arm, Shoulder and Hand score, or active range of motion was observed between groups. Postoperative deterioration of radiological joint status was similar in the ulnohumeral and radiocapitellar joints of both groups. Re-ossification of the fossa fenestration did not differ significantly between groups.
We compared the outcomes of the mini-open Outerbridge-Kashiwagi procedure according to radiocapitellar joint status. Short-term results were satisfactory in both groups, but resting pain associated with newly developed anterior loose bodies led to a poor outcome in group 2.
TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.
根据桡骨头关节的放射学分级，比较采用小切口外侧桥-Kashiwagi手术治疗的患者的临床和放射学结果。
纳入2004年3月至2010年2月间诊断为原发性肘关节关节炎的63例患者。无桡骨头关节病和有桡骨头关节病的患者分别被分配到第1组（n = 34）和第2组（n = 29）。平均随访期为51个月。使用静息时肘关节疼痛情况、Morrey疼痛评分、Mayo肘关节功能评分、手臂、肩部和手部功能障碍评分以及主动活动范围对两组的临床结果进行比较。评估放射学结果，包括游离体的存在和开窗处的再骨化情况。
在末次随访检查时，第1组无患者报告静息时肘关节疼痛，第2组有4例患者报告有静息时肘关节疼痛。所有疼痛均位于桡侧，2例患者疼痛加重。两组的Mayo肘关节功能评分、手臂、肩部和手部功能障碍评分以及主动活动均有改善。两组之间在Morrey疼痛评分、Mayo肘关节功能评分、手臂、肩部和手部功能障碍评分或主动活动范围方面未观察到显著差异。两组尺肱关节和桡骨头关节的放射学关节状态术后恶化情况相似。两组之间开窗处的再骨化情况无显著差异。
我们根据桡骨头关节状态比较了小切口外侧桥-Kashiwagi手术的结果。两组的短期结果均令人满意，但第2组中与新出现的前方游离体相关的静息疼痛导致了较差的结果。
研究类型/证据水平：治疗性III级。
