Center of Excellent in Upper Extremity Reconstruction and Sports Medicine, Department of Orthopaedics, HRH Princess Maha Chakri Sirindhorn Medical Center, 37692Srinakharinwirot University, Nakhon Nayok, Thailand.
J Orthop Surg (Hong Kong). 2022 May-Aug;30(2):10225536221113243. doi: 10.1177/10225536221113243.
Among the causative lesions of lateral elbow pain, atraumatic posterolateral rotatory instability (PLRI) is a rare condition, but it produces pain and disability to the elbow. It still lacks published specific treatment literature. According to the development of arthroscopy, the arthroscopic lateral collateral ligament (LCL) imbrication can possibly be an alternative minimal invasive procedure that can eradicate the atraumatic PLRI. To report clinical results of arthroscopic LCL imbrication for the treatment on atraumatic PLRI elbow. Thirty-three patients with chronic atraumatic lateral elbow pain were presented to our institution between July 2015 and December 2021. Eight patients were diagnosed with atraumatic PLRI and underwent arthroscopic LCL imbrication. Comparison between the pre- and post-operative scores were recorded, which were The Quick-Disabilities of Arm, Shoulder, and Hand (Quick-DASH) score, Mayo Elbow Performance Index (MEPI) and Visual Analog Scale for pain (VAS). Mean follow-up was 16 months (9-24 months). Comparing between pre-operation and post-operation, all of eight patients had significant improved Quick-DASH score (mean 55.62 vs 7.62, = .004), MEPI (mean 50.00 vs 96.87, = .000) and VAS for pain (mean 8.14 vs 1.28, = .000). Atraumatic PLRI is a concerning lesion in patients with lateral elbow pain. Arthroscopic LCL imbrication can be simultaneously performed with other lateral elbow pain causations, such as tennis elbow and pathological plica, and provide painless, stable, and functional elbow.
Case Series (Level of evidence: 4).
在导致外侧肘部疼痛的病变中,非创伤性后外侧旋转不稳定(PLRI)较为少见,但会引起肘部疼痛和功能障碍。目前仍缺乏相关的特定治疗文献。随着关节镜技术的发展,关节镜下外侧副韧带(LCL)交织术可能成为一种治疗非创伤性 PLRI 的微创方法。本文旨在报告关节镜下 LCL 交织术治疗非创伤性 PLRI 肘部的临床结果。
2015 年 7 月至 2021 年 12 月,我院共收治 33 例慢性非创伤性外侧肘部疼痛患者。其中 8 例被诊断为非创伤性 PLRI,并接受了关节镜下 LCL 交织术。记录术前和术后评分,包括 Quick-Disabilities of Arm, Shoulder, and Hand(Quick-DASH)评分、Mayo 肘部功能指数(MEPI)和疼痛视觉模拟量表(VAS)。
平均随访 16 个月(9-24 个月)。8 例患者的 Quick-DASH 评分(术前 55.62 分,术后 7.62 分, =.004)、MEPI(术前 50.00 分,术后 96.87 分, =.000)和 VAS 评分(术前 8.14 分,术后 1.28 分, =.000)均有显著改善。
非创伤性 PLRI 是引起肘部外侧疼痛的一个重要病变。关节镜下 LCL 交织术可同时治疗其他引起肘部外侧疼痛的病因,如网球肘和病理性滑膜皱襞,并可提供无痛、稳定和功能正常的肘部。
病例系列(证据等级 4)。