Yoon Jong Pil, Chung Seok Won, Yi Jae Hyuck, Lee Byoung-Joo, Jeon In-Ho, Jeong Won-Ju, Lee Hyun-Joo
Department of Orthopaedic Surgery, Kyungpook National University Hospital, Daegu, Republic of Korea.
Department of Orthopaedic Surgery, Konkuk University School of Medicine, Seoul, Republic of Korea.
Arthroscopy. 2015 Jul;31(7):1232-7. doi: 10.1016/j.arthro.2015.02.006. Epub 2015 Mar 29.
The purpose of this study was to analyze factors affecting the treatment outcomes and prognoses of arthroscopic debridement for refractory lateral epicondylitis.
We included 45 patients who had undergone arthroscopic extensor carpi radialis brevis release for chronic refractory lateral epicondylitis between October 2008 and December 2012. Demographic data, magnetic resonance imaging studies, and arthroscopic findings were examined and analyzed.
The mean age of the enrolled patients (23 men and 22 women) was 45.9 ± 7.8 years, and the mean follow-up duration was 26.9 ± 9.0 months. All the patients showed significant clinical improvement on all parameters assessed using the visual analog scale (6.9 preoperatively to 0.9 postoperatively), the Upper Extremity Functional Scale (34.8 to 66.7), and the Mayo Elbow Score (63.5 to 92.3) (P < .05). There were no reports of serious surgical complications. At final follow-up, 37 patients (82.2%) were satisfied with their outcomes whereas 8 patients (17.8%) were dissatisfied. In terms of demographic factors, female sex was significantly different between the 2 groups. On preoperative magnetic resonance imaging, 7 patients in the satisfied group (18.9%) had a definite tendon lesion (grade III defect, ≥6 mm) whereas 6 patients in the dissatisfied group (75%) had a grade III defect (P = .016).
Overall, clinical outcome scores showed improvement after arthroscopic extensor carpi radialis brevis release for refractory lateral epicondylitis. However, preoperative tendon status and sex were associated with dissatisfaction and poor postoperative outcomes after the arthroscopic release procedure.
Level IV, therapeutic case series.
本研究旨在分析影响难治性外侧上髁炎关节镜下清创治疗效果及预后的因素。
我们纳入了2008年10月至2012年12月间因慢性难治性外侧上髁炎接受关节镜下桡侧腕短伸肌松解术的45例患者。对人口统计学数据、磁共振成像研究及关节镜检查结果进行了检查和分析。
纳入患者（23例男性和22例女性）的平均年龄为45.9±7.8岁，平均随访时间为26.9±9.0个月。所有患者在使用视觉模拟量表（术前6.9，术后0.9）、上肢功能量表（34.8至66.7）和梅奥肘关节评分（63.5至92.3）评估的所有参数上均显示出显著的临床改善（P<.05）。未报告严重手术并发症。在末次随访时，37例患者（82.2%）对其结果满意，而8例患者（17.8%）不满意。在人口统计学因素方面，两组间女性性别存在显著差异。术前磁共振成像显示，满意组7例患者（18.9%）有明确的肌腱病变（III级缺损，≥6mm），而不满意组6例患者（75%）有III级缺损（P = .016）。
总体而言，难治性外侧上髁炎关节镜下桡侧腕短伸肌松解术后临床结果评分有所改善。然而，术前肌腱状况和性别与关节镜松解术后的不满意及不良术后结果相关。
IV级，治疗性病例系列。
