Department of Orthopaedic Sports Medicine, Klinikum Rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany.
Department of Trauma and Orthopedic Surgery, HELIOS Klinikum München West, Munich, Germany.
Knee Surg Sports Traumatol Arthrosc. 2018 Jan;26(1):312-317. doi: 10.1007/s00167-017-4630-7. Epub 2017 Jul 1.
The purpose of this retrospective study was to report on the functional outcome after arthroscopic arthrolysis in patients with post-traumatic or degenerative elbow stiffness. It was hypothesized that this operative procedure leads to improved range of motion (ROM) and improved functional outcome in both groups.
Patients who underwent arthroscopic arthrolysis of the elbow between 2010 and 2015 were included in this study. Forty-two patients with an average age of 41.0 ± 13.5 years were available for evaluation. The mean follow-up was 28.3 ± 14.9 months. With regard to aetiology of elbow contractures, patients were divided into post-traumatic (group A) and degenerative (group B) cohort. General patients' data, previous surgical treatment and ROM were recorded. At follow-up evaluation, the clinical outcome was assessed by the ROM, visual analogue scale (VAS) for pain assessment and the Elbow Self-Assessment Score (ESAS).
The mean arc of motion of group A (n = 20) increased from preoperatively 74.3° to 120.5° postoperatively (p < 0.001); group B (n = 22) showed an improvement of 104.6° preoperatively to 123.4° after surgery (p = 0.002). Mean improvement was 46.3° ± 27.5° in group A and 16.4° ± 19.4° in group B. Mean post-operative VAS was 0.9 ± 1.5 in group A and 1.3 ± 2.2 in group B. 92.9% of patients achieved a functional arc of elbow motion >100°. The ESAS indicated good to excellent clinical outcome showing 88.8 ± 10.0 points in group A and 84.1 ± 21.4 points in group B. Thirty-six patients (85.7%) returned to their previous work level after surgery.
Arthroscopic arthrolysis is an effective treatment option for patients with restriction in elbow motion reasoned by post-traumatic or degenerative changes. Both groups showed a significant improvement of ROM and comparable outcome scores.
Therapeutic study, Level IV.
本回顾性研究的目的是报告创伤后或退行性肘僵硬患者关节镜松解术后的功能结果。假设该手术操作可改善两组患者的活动范围（ROM）和功能结果。
本研究纳入了 2010 年至 2015 年间行关节镜下肘部松解术的患者。共有 42 例平均年龄为 41.0±13.5 岁的患者可进行评估。平均随访时间为 28.3±14.9 个月。根据肘部挛缩的病因，患者分为创伤后（A 组）和退行性（B 组）队列。记录一般患者数据、既往手术治疗和 ROM。在随访评估时，通过 ROM、疼痛评估的视觉模拟量表（VAS）和肘部自我评估量表（ESAS）评估临床结果。
A 组（n=20）的平均运动弧从术前 74.3°增加到术后 120.5°（p<0.001）；B 组（n=22）术前为 104.6°，术后为 123.4°（p=0.002）。A 组平均改善 46.3°±27.5°，B 组为 16.4°±19.4°。A 组术后 VAS 平均为 0.9±1.5，B 组为 1.3±2.2。92.9%的患者获得了>100°的功能性肘部运动弧。ESAS 表明，A 组的临床结果为良好至优秀，得分为 88.8±10.0，B 组为 84.1±21.4。36 例患者（85.7%）术后返回至之前的工作水平。
关节镜松解术是治疗创伤后或退行性改变引起的肘部运动受限的有效治疗选择。两组患者的 ROM 均有显著改善，且功能评分相当。
治疗性研究，IV 级。
