Department of Orthopaedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Orthopaedics, National Trauma Center, National Academy of Medical Sciences, Kathmandu, Nepal.
BMC Musculoskelet Disord. 2019 Jun 15;20(1):285. doi: 10.1186/s12891-019-2666-1.
Primary purpose of this study is to compare the clinical outcomes of patients undergoing arthroscopic arthrolysis in posttraumatic and non-traumatic elbow stiffness. Secondary aims are to compare the level of satisfaction and complications.
We retrospectively evaluated the patients undergoing arthroscopic elbow arthrolysis between January 2008 and September 2015 and have completed a minimum 2-year follow-up. Total of 141 patients (male = 90; female = 51) with 143 elbows (posttraumatic, n = 75; non-traumatic, n = 68) with an average age of 33 years were available for final evaluation. The average follow-up period was 44 months. We used the Mayo Elbow Performance Index (MEPI) score, range of motion (ROM), Visual Analogue Scale (VAS) to measure clinical outcomes. The level of satisfaction was measured by a self-constructed questionnaire.
All parameters were significantly improved postoperatively (P < 0.01). However, statistically significant differences were not present in the rate of postoperative improvement of elbow ROM (P = 0.08) and MEPI (P = 0.21) in both groups. According to MEPI, 72(96%) elbows in posttraumatic and 60(88%) elbows in non-traumatic group were rated as good to excellent. No statistically significant differences were observed in the level of satisfaction (P = 0.76) and rate of complications (P = 0.91).
Arthroscopic arthrolysis is an effective tool and a good option for the treatment of patients with posttraumatic and non-traumatic elbow stiffness. The rate of elbow ROM and MEPI score improvements were significant and comparable postoperatively with a high level of patient's satisfaction. However, postoperative rehabilitation is equally essential to maintain intraoperative elbow ROM, to attain optimal outcome and to prevent complications.
本研究的主要目的是比较创伤后和非创伤性肘僵硬患者行关节镜下松解术的临床疗效。次要目的是比较满意度和并发症水平。
我们回顾性评估了 2008 年 1 月至 2015 年 9 月间行关节镜下肘松解术的患者,所有患者均完成了至少 2 年的随访。共有 141 例患者(男性 90 例,女性 51 例)的 143 肘(创伤后,n=75;非创伤后,n=68)纳入最终评估,平均年龄 33 岁。平均随访时间为 44 个月。我们使用 Mayo 肘功能评分(MEPI)、活动范围(ROM)和视觉模拟评分(VAS)来衡量临床疗效。满意度通过自制问卷进行测量。
所有参数术后均显著改善(P<0.01)。然而,两组患者术后 ROM 和 MEPI 的改善率差异无统计学意义(P=0.08 和 P=0.21)。根据 MEPI,72 例(96%)创伤后肘和 60 例(88%)非创伤后肘被评为良好至优秀。两组患者的满意度(P=0.76)和并发症发生率(P=0.91)差异无统计学意义。
关节镜下松解术是治疗创伤后和非创伤后肘僵硬的有效方法,也是一种较好的选择。术后 ROM 和 MEPI 评分的改善明显且相似,患者满意度高。然而,术后康复同样至关重要,以保持术中 ROM,获得最佳疗效并预防并发症。