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使用同侧肱三头肌腱移植治疗复发性肘关节后外侧不稳定患者的长期临床结果。

Long-term clinical results in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft.

作者信息

Kastenskov Christian, Rasmussen Jeppe Vejlgaard, Ovesen Janne, Olsen Bo Sanderhoff

机构信息

Shoulder and Elbow Unit, Orthopedic Department, Herlev and Gentofte Hospital, Herlev, Denmark.

Shoulder and Elbow Unit, Orthopedic Department, Herlev and Gentofte Hospital, Herlev, Denmark.

出版信息

J Shoulder Elbow Surg. 2017 Jun;26(6):1052-1057. doi: 10.1016/j.jse.2017.01.015. Epub 2017 Mar 27.

Abstract

BACKGROUND

The aim was to report the long-term functional and radiologic outcomes in patients treated for recurrent posterolateral elbow joint instability using an ipsilateral triceps tendon graft.

METHODS

We included 18 patients previously treated for posterolateral elbow joint instability and evaluated for clinical results in 2003. Fifteen patients were examined with a mean follow-up period of 19 years (range, 17-22 years). We performed the clinical follow-up with clinical examination of stability, range of motion, pain score on a visual analog scale, Mayo Elbow Performance Score, and Danish version of Oxford Elbow Score. Furthermore, conventional anteroposterior and side-view radiographs of the elbow were obtained to evaluate osteoarthritis, calcifications in the ligaments, and joint subluxation. We evaluated the radiographs by the size of osteophytes, joint space narrowing, and subchondral sclerosis and classified the findings into 3 categories: no osteoarthritis, osteoarthritis, and severe osteoarthritis.

RESULTS

All patients had a clinically stable elbow. None had pain while inactive or locking of the joint, and 4 had decreased range of motion. Two patients had a positive pivot-shift stress test, indicating laxity. The mean Mayo Elbow Performance Score was 93 (range, 70-100). The mean Oxford Elbow Score was 45. We observed 5 patients with osteoarthritis and 1 patient with severe osteoarthritis.

CONCLUSION

The technique reported by Olsen and Søjbjerg in 2003 gives good long-term results in the treatment of symptomatic posterolateral elbow joint instability, though the development of elbow joint osteoarthritis may decrease the surgical result in the coming years.

摘要

背景

目的是报告使用同侧肱三头肌腱移植治疗复发性肘关节后外侧不稳患者的长期功能和影像学结果。

方法

我们纳入了18例曾接受肘关节后外侧不稳治疗并于2003年接受临床结果评估的患者。对15例患者进行了检查,平均随访期为19年(范围17 - 22年)。我们通过稳定性临床检查、活动范围、视觉模拟量表疼痛评分、梅奥肘关节功能评分和丹麦版牛津肘关节评分进行临床随访。此外,还获得了肘关节的常规前后位和侧位X线片,以评估骨关节炎、韧带钙化和关节半脱位情况。我们根据骨赘大小、关节间隙变窄和软骨下硬化情况对X线片进行评估,并将结果分为3类:无骨关节炎、骨关节炎和严重骨关节炎。

结果

所有患者肘关节临床稳定。无人在静息时疼痛或关节绞锁,4例活动范围减小。2例患者 pivot - shift 应力试验阳性,提示松弛。梅奥肘关节功能评分平均为93分(范围70 - 100分)。牛津肘关节评分平均为45分。我们观察到5例患者有骨关节炎,1例有严重骨关节炎。

结论

奥尔森和索伊贝里在2003年报告的技术在治疗有症状的肘关节后外侧不稳方面取得了良好的长期效果,尽管未来几年肘关节骨关节炎的发展可能会降低手术效果。

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