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桡肱关节滑膜皱襞关节镜下切除术的短期疗效:64例手术病例系列

Short-term results after arthroscopic resection of synovial plicae in the radiohumeral joint: a case series of 64 procedures.

作者信息

Brahe Pedersen Jens, Kristensen Pia Kjær, Mønsted Peter, Thillemann Theis Muncholm

机构信息

Regional Hospital Horsens, Sundvej 30, 8700 Horsens, Denmark.

Department of Orthopedics, Regional Hospital Horsens, Sundvej 30, 8700 Horsens, Denmark.

出版信息

SICOT J. 2017;3:42. doi: 10.1051/sicotj/2017021. Epub 2017 Jun 7.

Abstract

INTRODUCTION

Painful Synovial Plicae (SP) in the posterolateral corner of the radiohumeral joint may be confused with lateral epicondylitis. The SP may impinge between the radial head and the humeral capitellum causing pain and snapping. The aim of this study was to evaluate the short-term results after arthroscopic plica resection of the elbow.

METHODS

In this case series, we included a consecutive series of 64 arthroscopies (60 patients) with arthroscopic plica resection of the elbow. Inclusion criteria were six months of lateral elbow pain and unsuccessful conservative treatment. Patients had either ultrasonography verified plicae or pain on palpation of the plica. Patients were evaluated with an Oxford Elbow Score (OES) preoperatively, after three months and after mean 22 months (range: 12-31) of follow-up. Furthermore, baseline characteristics were recorded including, gender, age, body mass index (BMI), occupation, smoking and cartilage damage.

RESULTS

The mean age was 44 years (range: 18-66). In 13 elbows, International Cartilage Repair Society (ICRS) grade 1 lesions were present in association with the plica. Preoperatively the mean OES was 19 (95% CI: 17-20). At three and 22 month follow-up the OES increased to 33 (95% CI: 30-36) and 35 (95% CI: 32-38), respectively (p < 0.001). Cartilage injury and gender did not affect the outcome. We reported no complications.

DISCUSSION

Arthroscopic plica resection of the elbow indicates an improved OES after three and 22 months. A randomized prospective trial is needed to validate the effect of arthroscopic treatment of synovial elbow plicae.

摘要

引言

桡肱关节后外侧角的疼痛性滑膜皱襞(SP)可能会与外侧上髁炎相混淆。滑膜皱襞可能会在桡骨头和肱骨小头之间受到挤压,从而引起疼痛和弹响。本研究的目的是评估肘关节镜下皱襞切除术的短期效果。

方法

在本病例系列中,我们纳入了连续64例接受肘关节镜下皱襞切除术的关节镜检查(60例患者)。纳入标准为肘部外侧疼痛6个月且保守治疗无效。患者要么经超声检查证实有皱襞,要么在触诊皱襞时有疼痛。术前、术后3个月以及平均随访22个月(范围:12 - 31个月)时,使用牛津肘关节评分(OES)对患者进行评估。此外,记录基线特征,包括性别、年龄、体重指数(BMI)、职业、吸烟情况和软骨损伤情况。

结果

平均年龄为44岁(范围:18 - 66岁)。在13个肘关节中,与皱襞相关存在国际软骨修复协会(ICRS)1级损伤。术前平均OES为19(95%可信区间:17 - 20)。在3个月和22个月随访时,OES分别增至33(95%可信区间:30 - 36)和35(95%可信区间:32 - 38)(p < 0.001)。软骨损伤和性别不影响结果。我们未报告并发症。

讨论

肘关节镜下皱襞切除术显示术后3个月和22个月时OES有所改善。需要进行一项随机前瞻性试验来验证关节镜治疗肘关节滑膜皱襞的效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3d72/5461719/a4ef0088ae00/sicotj-3-42-fig1.jpg

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