Kim Doo Sup, Chung Hoe Jeong, Yi Chang-Ho, Kim Seong-Hyeon
Orthopedics. 2018 Jul 1;41(4):237-247. doi: 10.3928/01477447-20180621-04. Epub 2018 Jun 26.
Numerous surgical options have been introduced for the treatment of chronic refractory lateral epicondylitis of the elbow, but it remains unclear which option is superior. The clinical outcomes of an open surgery group and an arthroscopic surgery group were evaluated, and the results of the 2 procedures were compared. From among patients with lateral epicondylitis refractory to 6 months of conservative treatment, 68 patients satisfying study criteria were recruited. Open surgery was performed in 34 cases (group 1), and arthroscopic surgery was performed in 34 cases (group 2). Compared with preoperatively, the 2 groups had significantly improved values for grip strength, range of motion, and Disabilities of the Arm, Shoulder and Hand score at 12 months postoperatively. Group 1 had significantly greater improvements in grip strength and visual analog scale pain score compared with group 2 (P=.048 vs P=.006). Group 2 had significantly greater (P=.045) improvement in pronation compared with group 1. Group 2 returned to work sooner than group 1. On the questionnaire regarding satisfaction with surgery 24 months postoperatively, 4 patients (12%) in group 2 reported dissatisfaction compared with no patients in group 1. Open surgery and arthroscopic surgery both yielded good clinical results. Nonetheless, for patients requiring muscle strength or having severe pain at work, open surgery would be more effective. [Orthopedics. 2018; 41(4):237-247.].
为治疗慢性难治性肱骨外上髁炎,已引入了多种手术选择,但哪种选择更优仍不明确。评估了开放手术组和关节镜手术组的临床结果,并比较了这两种手术的结果。从经6个月保守治疗仍难治的肱骨外上髁炎患者中,招募了68例符合研究标准的患者。34例患者接受了开放手术(第1组),34例患者接受了关节镜手术(第2组)。与术前相比,两组术后12个月时的握力、活动范围以及手臂、肩部和手部功能障碍评分均有显著改善。与第2组相比,第1组的握力和视觉模拟评分疼痛评分改善更为显著(P = 0.048对P = 0.006)。与第1组相比,第2组的旋前改善更为显著(P = 0.045)。第2组比第1组更早恢复工作。在术后24个月关于手术满意度的问卷中,第2组有4例患者(12%)表示不满意,而第1组无患者表示不满意。开放手术和关节镜手术均取得了良好的临床效果。尽管如此,对于需要肌肉力量或工作时疼痛严重的患者,开放手术可能更有效。[《骨科》。2018;41(4):237 - 247。]