Miyamura Satoshi, Temporin Ko, Miyata Sataka, Miyake Tasuku, Shimada Kozo
Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka; Department of Orthopaedic Surgery, Osaka University, Graduate School of Medicine, Suita, Japan.
Department of Orthopaedic Surgery, Japan Community Health Care Organization Osaka Hospital, Osaka.
Arthroscopy. 2022 Dec;38(12):3120-3129. doi: 10.1016/j.arthro.2022.07.019. Epub 2022 Aug 10.
To qualify and quantify the changes in magnetic resonance imaging (MRI) signals in the extensor tendons after arthroscopic debridement for lateral epicondylitis and evaluate the association between MRI findings and temporal clinical results by comparisons between recovered and unrecovered cases.
Thirty-four patients with refractory lateral epicondylitis treated with arthroscopic debridement were divided into recovered (n = 24) and unrecovered (n = 10) groups according to the Japanese Orthopaedic Association-Japan Elbow Society score. This study included any patients who underwent both the pre- and postoperative MRI and excluded patients with a previous history of any elbow surgery. Pre- and postoperative MRI findings were qualitatively categorized into 4 grades, quantified by measuring the percentage of tendinopathy area, and compared between the groups.
Preoperatively, grading scores and percentages did not show significant differences between groups (P = .050 and .519). The respective numbers of patients with grades 1, 2, 3, and 4 were 1 (4%), 3 (13%), 10 (42%), and 10 (42%) in the recovered group; and 1 (10%), 2 (20%), 7 (70%), and 0 (0%) in the unrecovered group. The average percentages in the recovered and unrecovered groups were 42.3% (73.9 mm/168.4 mm); and 36.5% (50.5 mm/131.0 mm). However, postoperatively, they were significantly lower in the recovered group than in the unrecovered group (P = .007 and .014). The numbers and percentages in the recovered and unrecovered groups were 15 (63%), 8 (33%), 1 (4%), and 0 (0%) and 17.0% (28.6mm/169.8mm) and 2 (20%), 3 (30%), 5 (50%), and 0 (0%) and 30.5% (39.0 mm/131.8 mm).
Qualitative and quantitative MRI is useful for evaluating the progress of tendon healing after arthroscopic debridement. In the recovered and unrecovered groups, improvement of tendinopathy area were 60% versus 16%, indicating that postoperative MRI findings reflect clinical outcomes.
IV, case series with subgroup analysis.
对经关节镜清创术治疗外侧上髁炎后伸肌腱磁共振成像（MRI）信号的变化进行定性和定量分析，并通过比较恢复和未恢复病例来评估MRI表现与短期临床结果之间的关联。
34例接受关节镜清创术治疗的难治性外侧上髁炎患者，根据日本骨科协会-日本肘关节协会评分分为恢复组（n = 24）和未恢复组（n = 10）。本研究纳入所有接受术前和术后MRI检查的患者，排除既往有任何肘部手术史的患者。术前和术后MRI表现定性分为4级，通过测量肌腱病变区域的百分比进行量化，并在两组之间进行比较。
术前，分级评分和百分比在两组之间无显著差异（P = 0.050和0.519）。恢复组中1级、2级、3级和4级患者的数量分别为1例（4%）、3例（13%）、10例（42%）和10例（42%）；未恢复组中分别为1例（10%）、2例（20%）、7例（70%）和0例（0%）。恢复组和未恢复组的平均百分比分别为42.3%（73.9 mm/168.4 mm）和36.5%（50.5 mm/131.0 mm）。然而，术后，恢复组的这些指标显著低于未恢复组（P = 0.007和0.014）。恢复组和未恢复组的数量和百分比分别为15例（63%）、8例（33%）、1例（4%）和0例（0%）以及17.0%（28.6mm/169.8mm），和2例（20%）、3例（30%）、5例（50%）和0例（0%）以及30.5%（39.0 mm/131.8 mm）。
定性和定量MRI有助于评估关节镜清创术后肌腱愈合的进展。在恢复组和未恢复组中，肌腱病变区域的改善分别为60%和16%，表明术后MRI表现反映了临床结果。
IV，带有亚组分析的病例系列研究。
