Ge Susan Mengxiao, Marwan Yousef, Abduljabbar Fahad H, Morelli Moreno, Turcotte Robert E
Division of Orthopaedic Surgery, McGill University Health Centre, 1650 Cedar Ave A5-169, Montreal, QC, H3G 1A4, Canada.
Division of Orthopaedic Surgery, Department of Surgery, Faculty of Medicine, Kuwait University, Kuwait City, Kuwait.
Eur J Orthop Surg Traumatol. 2020 Dec;30(8):1333-1344. doi: 10.1007/s00590-020-02710-6. Epub 2020 Jun 5.
Intra- and juxta-articular osteoid osteoma (OO) is rare and can result in irreversible joint damage. Recently, arthroscopic surgery is being used more and more to avoid complications associated with other treatment modalities.
On October 13, 2019, we conducted a systematic review of the literature available in PubMed and EMBASE regarding the arthroscopic management of OO involving the joints of the upper extremity. Predetermined inclusion criteria were used to include any relevant article published on and before that date for further analysis. Treatment success rate and tumor recurrence rate were considered the primary outcomes in our analysis.
Out of 113 studies, 19 met our inclusion criteria. Of the 32 reported cases in these 19 articles, ten involved the shoulder joint, 19 involved the elbow joint and three involved the wrist joint. Overall treatment success rate was 93.8%. Tumor recurrence rate was 0.0%. No postoperative complications (0.0%) were reported among cases involving the shoulder joint. Two out of 24 (8.3%) patients with elbow OO failed arthroscopic treatment due to incomplete excision, and two (4%) experienced minor complications. Among the three cases of wrist OO, two (66.7%) patients had residual postoperative pain and decreased hand grip strength.
Arthroscopic management of OO of the upper extremity joints is highly successful and results in no tumor recurrence; however, there is a risk of incomplete resection in areas more difficult to access by arthroscopy.
关节内及关节周围骨样骨瘤(OO)较为罕见,可导致不可逆的关节损伤。近来,关节镜手术的应用越来越广泛,以避免与其他治疗方式相关的并发症。
2019年10月13日,我们对PubMed和EMBASE中有关上肢关节OO关节镜治疗的文献进行了系统综述。采用预先确定的纳入标准纳入该日期及之前发表的任何相关文章以进行进一步分析。治疗成功率和肿瘤复发率被视为我们分析中的主要结局。
在113项研究中,19项符合我们的纳入标准。在这19篇文章中报告的32例病例中,10例累及肩关节,19例累及肘关节,3例累及腕关节。总体治疗成功率为93.8%。肿瘤复发率为0.0%。肩关节病例中未报告术后并发症(0.0%)。24例肘关节OO患者中有2例(8.3%)因切除不完全而关节镜治疗失败,2例(4%)出现轻微并发症。在3例腕关节OO病例中,2例(66.7%)患者术后有残留疼痛且握力下降。
上肢关节OO的关节镜治疗非常成功,且无肿瘤复发;然而,在关节镜难以到达的区域存在切除不完全的风险。