Department of Orthopaedic Surgery, Duke University Medical Center, Durham, NC, USA.
Arthritis Research UK Centre for Sport, Exercise and Osteoarthritis, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
J Shoulder Elbow Surg. 2020 Apr;29(4):689-698. doi: 10.1016/j.jse.2019.12.003.
Primary elbow osteoarthritis (PEOA) is a debilitating disease that can be difficult to treat. Osteocapsular débridement (OD) has been described through various approaches, including arthroscopic and open approaches, with successful outcomes in treating PEOA. There is insufficient evidence in the literature to date to demonstrate the superiority of any approach. The purpose of this review was to compare the clinical results of arthroscopic vs. open OD for PEOA.
The online databases PubMed, Embase (Elsevier), and Scopus (Elsevier) were searched from inception through April 1, 2018, for clinical studies reporting on OD. Studies were stratified based on an arthroscopic vs. open approach. Weighted means were calculated for surgical and patient-reported outcomes.
We included 30 studies, reporting on 871 patients and 887 elbows, with a mean follow-up period of 44.3 ± 25.5 months. Of these studies, 15 (420 elbows) reported on open OD, 14 (456 elbows) reported arthroscopic OD, and 1 reported on a cohort of each approach (open in 5 elbows and arthroscopic in 6). The Mayo Elbow Performance Score improved by 28.6 ± 4.57 in the open group vs. 26.6 ± 7.24 in the arthroscopic group. Flexion improved by 19° ± 6° in the open group and 10° ± 6° in the arthroscopic group. Extension improved by 11° ± 5° in the open group and 11° ± 6° in the arthroscopic group.
Open OD and arthroscopic OD are effective surgical treatment options for patients with symptomatic PEOA, reliably improving flexion, extension, and functional outcome scores with low complication rates.
原发性肘关节炎（PEOA）是一种使人虚弱的疾病，难以治疗。已经通过各种方法（包括关节镜和开放方法）描述了骨膜切除术（OD），在治疗 PEOA 方面取得了成功的结果。迄今为止，文献中没有足够的证据表明任何方法具有优势。本综述的目的是比较关节镜与开放 OD 治疗 PEOA 的临床结果。
从建立到 2018 年 4 月 1 日，通过在线数据库 PubMed、Embase（Elsevier）和 Scopus（Elsevier）搜索报告 OD 的临床研究。研究基于关节镜与开放方法进行分层。计算了手术和患者报告结果的加权平均值。
我们纳入了 30 项研究，共报告了 871 例患者和 887 个肘部，平均随访时间为 44.3 ± 25.5 个月。其中，15 项（420 个肘部）研究报告了开放 OD，14 项（456 个肘部）报告了关节镜 OD，1 项报告了两种方法的队列（5 个肘部开放，6 个肘部关节镜）。在开放组中， Mayo 肘功能评分提高了 28.6 ± 4.57，而在关节镜组中提高了 26.6 ± 7.24。在开放组中，屈曲度改善了 19° ± 6°，而在关节镜组中改善了 10° ± 6°。在开放组中，伸展度改善了 11° ± 5°，而在关节镜组中改善了 11° ± 6°。
开放 OD 和关节镜 OD 是治疗有症状的 PEOA 的有效手术治疗选择，可靠地改善了屈曲、伸展和功能结果评分，且并发症发生率低。
