Houston Methodist Orthopedic and Sports Medicine, Houston, Texas, U.S.A.
Houston Methodist Orthopedic and Sports Medicine, Houston, Texas, U.S.A..
Arthroscopy. 2017 Dec;33(12):2255-2262. doi: 10.1016/j.arthro.2017.08.247.
The purpose of this investigation was to determine whether arthroscopic debridement of primary elbow osteoarthritis results in statistically significant and clinically relevant improvement in (1) elbow range of motion and (2) clinical outcomes with (3) low complication and reoperation rates.
A systematic review was registered with PROSPERO and performed using PRISMA guidelines. Databases were searched for studies that investigated the outcomes of arthroscopic debridement for the treatment of primary osteoarthritis of the elbow in adult human patients. Study methodological quality was analyzed. Studies that included post-traumatic arthritis were excluded. Elbow motion and all elbow-specific patient-reported outcome scores were eligible for analysis. Comparisons between preoperative and postoperative values from each study were made using 2-sample Z-tests (http://in-silico.net/tools/statistics/ztest) using a P value < .05.
Nine articles (209 subjects, 213 elbows, 187 males, 22 females, mean age 45.7 ± 7.1 years, mean follow-up 41.7 ± 16.3. months; 75% right, 25% left; 79% dominant elbow, 21% nondominant) were analyzed. Elbow extension (23.4°-10.7°, Δ 12.7°), flexion (115.9°-128.7°, Δ 12.8°), and global arc of motion (94.5°-117.6°, Δ 23.1°) had statistically significant and clinically relevant improvement following arthroscopic debridement (P < .0001 for all). There was also a statistically significant (P < .0001) and clinically relevant improvement in the Mayo Elbow Performance Score (60.7-84.6, Δ 23.9) postoperatively. Six patients (2.8%) had postoperative complications. Nine (4.2%) underwent reoperation.
Elbow arthroscopic debridement for primary degenerative osteoarthritis results in statistically significant and clinically relevant improvement in elbow range of motion and clinical outcomes with low complication and reoperation rates.
Systematic review of level IV studies.
本研究旨在确定关节镜下清创术是否能使原发性肘关节炎患者在（1）肘部活动度和（2）临床结果方面取得统计学意义和临床相关的改善，同时具有（3）较低的并发症和再手术率。
该研究进行了系统性回顾，并在 PROSPERO 上进行了注册，采用 PRISMA 指南进行。对研究关节镜下清创术治疗成人原发性肘关节炎的结果的数据库进行了检索。分析研究的方法学质量。排除创伤后关节炎的研究。符合分析标准的是肘部运动和所有肘特异性患者报告的结果评分。使用 2 样本 Z 检验（http://in-silico.net/tools/statistics/ztest）比较每个研究的术前和术后值，P 值<.05。
共纳入 9 篇文章（209 例患者，213 侧肘部，187 例男性，22 例女性，平均年龄 45.7±7.1 岁，平均随访时间 41.7±16.3 个月；75%为右侧，25%为左侧；79%为优势侧，21%为非优势侧）。关节镜下清创术后，肘部伸展（23.4°-10.7°，Δ 12.7°）、屈曲（115.9°-128.7°，Δ 12.8°）和总活动度（94.5°-117.6°，Δ 23.1°）均有统计学意义和临床相关改善（所有 P<.0001）。术后 Mayo 肘功能评分（60.7-84.6，Δ 23.9）也有统计学意义（P<.0001）和临床相关改善。6 例（2.8%）患者出现术后并发症，9 例（4.2%）患者行再次手术。
关节镜下清创术治疗原发性退行性骨关节炎可使肘部活动度和临床结果取得统计学意义和临床相关的改善，且并发症和再手术率较低。
IV 级研究的系统性综述。
