de Klerk Huub H, Welsink Chantal L, Spaans Anne J, Verweij Lukas P E, van den Bekerom Michel P J
Department of Orthopaedic Surgery, OLVG, Amsterdam, The Netherlands.
Department of Orthopaedic Surgery, St Maartenskliniek, Nijmegen/Boxmeer, The Netherlands.
EFORT Open Rev. 2020 Dec 4;5(12):874-882. doi: 10.1302/2058-5241.5.190095. eCollection 2020 Dec.
Primary osteoarthritis (OA) of the elbow can cause disabling symptoms of pain, locking, stiffness, and a limitation in the range of motion. There is no consensus regarding the role of open and arthroscopic debridement in the treatment of symptomatic primary elbow OA. The aim of this study is to systematically review the outcome of surgical debridement. A preoperative/postoperative comparison will be made between the two surgical procedures.All studies reporting on debridement as treatment for primary elbow OA with a minimum of one-year follow-up were included. Outcome parameters were functional results, complications, and performance scores.Data were extracted from 21 articles. The arthroscopic group consisted of 286 elbows with a weighted mean follow-up of 40 ± 17 months (range, 16-75). The open group consisted of 300 elbows with a weighted mean follow-up of 55 ± 20 months (range, 19-85). Both procedures showed improvement in Mayo Elbow Performance Score (MEPS), range of motion (ROM) flexion-extension, and ROM pronation-supination. Only in ROM flexion was a statistically significant difference in improvement seen between the groups in favour of the open group. The arthroscopic group showed improvement in pain visual analogue scale (VAS) scores. Nothing could be stated about pain VAS scores in the open group due to a lack of data. In the arthroscopic group 18 complications (6%) were described, in the open group 29 complications (12%).Surgical debridement is an effective treatment for the disabling symptoms of primary elbow OA with an acceptable complication rate. Cite this article: 2020;5:874-882. DOI: 10.1302/2058-5241.5.190095.
原发性肘关节骨关节炎（OA）可导致疼痛、交锁、僵硬等致残症状以及活动范围受限。对于开放性清创术和关节镜下清创术在有症状的原发性肘关节OA治疗中的作用，目前尚无共识。本研究的目的是系统评价手术清创的疗效。将对这两种手术方法进行术前/术后比较。纳入所有报道以清创术治疗原发性肘关节OA且随访至少1年的研究。结局参数包括功能结果、并发症和性能评分。从21篇文章中提取数据。关节镜组有286例肘关节，加权平均随访时间为40±17个月（范围16 - 75个月）。开放组有300例肘关节，加权平均随访时间为55±20个月（范围19 - 85个月）。两种手术方法在梅奥肘关节性能评分（MEPS）、屈伸活动范围（ROM）以及旋前 - 旋后ROM方面均有改善。仅在ROM屈曲方面，两组间改善情况存在统计学显著差异，开放组更具优势。关节镜组疼痛视觉模拟量表（VAS）评分有所改善。由于缺乏数据，无法说明开放组的疼痛VAS评分情况。关节镜组描述了18例并发症（6%），开放组描述了29例并发症（12%）。手术清创是治疗原发性肘关节OA致残症状的有效方法，并发症发生率可接受。引用本文：2020;5:874 - 882。DOI: 10.1302/2058 - 5241.5.190095。
