Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Department of Orthopedic Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, Korea.
Clin Orthop Surg. 2022 Sep;14(3):434-440. doi: 10.4055/cios21220. Epub 2022 Jul 21.
Lateral collateral ligament injuries may occur in patients with chronic lateral epicondylitis. The present study aimed to compare the clinical outcomes of arthroscopic debridement between patients with chronic lateral epicondylitis combined with a partial ligament injury and those without a ligament injury.
Between 2016 and 2018, patients who underwent arthroscopic debridement for lateral epicondylitis were evaluated. Partial injury to the lateral collateral ligament was defined as discontinuity or thinning with increased signal of the lateral ligament on magnetic resonance imaging and laxity with a firm endpoint in the varus or posterolateral rotatory stress test. Arthroscopic debridement was performed when there was no apparent instability in the stress test under fluoroscopic guidance after anesthesia. Patients with a ligament injury were compared with those without a ligament injury in terms of physical examination (varus stress test and posterolateral rotatory drawer test), pain visual analog scale, Mayo elbow performance score, and quick disabilities of the arm, shoulder and hand score.
There were 38 patients in the intact ligament group and 15 patients in the partial ligament injury group. There were 23 men and 30 women, and the mean patient age was 50 years (range, 27-77 years). The mean follow-up period was 30 months (range, 24-49 months). Instability was not observed in both groups at the last follow-up, and clinical scores improved significantly after surgery. Postoperative results did not show significant difference between the two groups. One patient in the partial injury group underwent revision open debridement owing to persistent pain.
The clinical outcomes of arthroscopic debridement for lateral epicondylitis did not show significant differences between patients with a partial ligament injury and those without a ligament injury.
慢性肘外侧炎患者可能发生外侧副韧带损伤。本研究旨在比较慢性肘外侧炎伴部分韧带损伤与不伴韧带损伤患者行关节镜清理术的临床疗效。
2016 年至 2018 年，对接受关节镜清理术治疗肘外侧炎的患者进行评估。外侧副韧带部分损伤定义为磁共振成像上外侧韧带连续性中断或变薄，信号增高，在内外翻或后外侧旋转应力量试验时韧带松弛但终末点固定。在麻醉下透视引导下应力试验未见明显不稳定时行关节镜清理术。比较韧带损伤患者与无韧带损伤患者的体格检查（内外翻应力试验和后外侧旋转抽屉试验）、疼痛视觉模拟评分、 Mayo 肘功能评分和快速上肢肩部手部功能障碍问卷评分。
完整韧带组 38 例，部分韧带损伤组 15 例。男 23 例，女 30 例，平均年龄 50 岁（2777 岁）。平均随访时间 30 个月（2449 个月）。末次随访时两组均未见不稳定，术后临床评分均显著改善。两组术后结果无显著差异。部分损伤组 1 例患者因持续疼痛行开放 Revision 清创术。
对于慢性肘外侧炎患者，行关节镜清理术治疗时，伴有部分韧带损伤与不伴韧带损伤的临床疗效无显著差异。
