Bi Wenzhi, Guo Biao, Xu Jian, Cui Honglin, Ma Wei, Yang Dongqiang, Fu Pengfei, Liu Yijun, Tian Jinxiang
Department of Orthopedics, Fuyang Hospital Affiliated to Bengbu Medical College (Fuyang People's Hospital), Fuyang Anhui, 236000, P. R. China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2022 Mar 15;36(3):268-273. doi: 10.7507/1002-1892.202109034.
To explore the effectiveness of computer-aided technology in the treatment of primary elbow osteoarthritis combined with stiffness under arthroscopy.
The clinical data of 32 patients with primary elbow osteoarthritis combined with stiffness between June 2018 and December 2020 were retrospectively analyzed. There were 22 males and 10 females with an average age of 53.4 years (range, 31-71 years). X-ray film and three-dimensional CT examinations showed osteophytes of varying degrees in the elbow joint. Loose bodies existed in 16 cases, and there were 7 cases combined with ulnar nerve entrapment syndrome. The median symptom duration was 2.5 years (range, 3 months to 22.5 years). The location of bone impingement from 0° extension to 140° flexion of the elbow joint was simulated by computer-aided technology before operation and a three-dimensional printed model was used to visualize the amount and scope of impinging osteophytes removal from the anterior and posterior elbow joint to accurately guide the operation. Meanwhile, the effect of elbow joint release and impinging osteophytes removal was examined visually under arthroscopy. The visual analogue scale (VAS) score, Mayo elbow performance score (MEPS), and elbow range of motion (extension, flexion, extension and flexion) were compared between before and after operation to evaluate elbow function.
The mean operation time was 108 minutes (range, 50-160 minutes). All 32 patients were followed up 9-18 months with an average of 12.5 months. There was no other complication such as infection, nervous system injury, joint cavity effusion, and heterotopic ossification, except 2 cases with postoperative joint contracture at 3 weeks after operation due to the failure to persist in regular functional exercises. Loose bodies of elbow and impinging osteophytes were removed completely for all patients, and functional recovery was satisfactory. At last follow-up, VAS score, MEPS score, extension, flexion, flexion and extension range of motion significantly improved when compared with preoperative ones ( 0.05).
Arthroscopic treatment of primary elbow osteoarthritis combined with stiffness using computer-aided technology can significantly reduce pain, achieve satisfactory functional recovery and reliable effectiveness.
探讨计算机辅助技术在关节镜下治疗原发性肘关节骨关节炎合并僵硬中的有效性。
回顾性分析2018年6月至2020年12月期间32例原发性肘关节骨关节炎合并僵硬患者的临床资料。其中男性22例,女性10例,平均年龄53.4岁(范围31 - 71岁)。X线片及三维CT检查显示肘关节有不同程度的骨赘形成。16例存在游离体,7例合并尺神经卡压综合征。症状持续时间中位数为2.5年(范围3个月至22.5年)。术前采用计算机辅助技术模拟肘关节从0°伸直位至140°屈曲位的骨撞击位置,并使用三维打印模型直观显示从肘关节前后方切除撞击性骨赘的数量和范围,以精确指导手术。同时,在关节镜下直观检查肘关节松解及撞击性骨赘切除的效果。比较手术前后的视觉模拟评分(VAS)、梅奥肘关节功能评分(MEPS)以及肘关节活动范围(伸直、屈曲、屈伸),以评估肘关节功能。
平均手术时间为108分钟(范围50 - 160分钟)。32例患者均获随访9 - 18个月,平均12.5个月。除2例术后因未坚持规律功能锻炼在术后3周出现关节挛缩外,无感染、神经系统损伤、关节腔积液及异位骨化等其他并发症。所有患者肘关节游离体及撞击性骨赘均完全切除,功能恢复满意。末次随访时,与术前相比,VAS评分、MEPS评分、伸直、屈曲、屈伸活动范围均显著改善(P<0.05)。
采用计算机辅助技术关节镜下治疗原发性肘关节骨关节炎合并僵硬可显著减轻疼痛,获得满意的功能恢复及可靠疗效。