Mohamadi Amin, Claessen Femke M A P, Ozkan Sezai, Kolovich Gregory P, Ring David, Chen Neal C
Massachusetts General Hospital, Boston, USA.
Massachusetts General Hospital, Boston, USA; Harvard Medical School, Boston, MA, USA; The University of Texas at Austin, USA.
Hand (N Y). 2017 Mar;12(2):193-196. doi: 10.1177/1558944716661993. Epub 2016 Jul 29.
This study addresses the prevalence of discrete pathophysiology accounting for patients' symptoms during diagnostic wrist arthroscopy in individuals with wrist pain without a specific preoperative diagnosis. Secondarily, we determined the number and type of surgeries subsequent to diagnostic wrist arthroscopy. Between January 2000 and January 2015, 135 diagnostic wrist arthroscopies were performed by 12 surgeons in 3 urban academic hospitals. We recorded the diagnostic findings of diagnostic wrist arthroscopy and any subsequent surgeries. One hundred and five patients had synovitis or a normal wrist (78%), 17 had likely age-appropriate changes (eg, central triangular fibrocartilage complex defects scapholunate changes) (13%), 8 (6%) were given uncommon diagnoses, and 5 (4%) had osteochondral defects. Sixteen patients (12%) had subsequent wrist surgery: 2 were for adverse events, 2 were carpal tunnel releases, and 12 were other surgeries. Diagnostic arthroscopy performed in the setting of an unclear preoperative diagnosis yielded limited diagnostic benefit.
本研究探讨了在术前无明确诊断的腕部疼痛患者中，诊断性腕关节镜检查时导致患者症状的离散病理生理学的患病率。其次，我们确定了诊断性腕关节镜检查后手术的数量和类型。2000年1月至2015年1月期间，3家城市学术医院的12名外科医生进行了135例诊断性腕关节镜检查。我们记录了诊断性腕关节镜检查的诊断结果以及任何后续手术。105例患者患有滑膜炎或腕关节正常（78%），17例有可能与年龄相符的改变（如中央三角纤维软骨复合体缺损、舟月关节改变）（13%），8例（6%）得到罕见诊断，5例（4%）有骨软骨缺损。16例患者（12%）随后接受了腕部手术：2例是针对不良事件，2例是腕管松解术，12例是其他手术。在术前诊断不明确的情况下进行的诊断性关节镜检查的诊断价值有限。
