Andrews Sports Medicine and Orthopaedic Center, Birmingham, AL, USA.
Andrews Sports Medicine and Orthopaedic Center, Birmingham, AL, USA.
J Shoulder Elbow Surg. 2023 Jun;32(6):1271-1279. doi: 10.1016/j.jse.2023.02.121. Epub 2023 Mar 11.
Although numerous studies exist evaluating the short-term clinical outcomes of patients who have undergone elbow arthroscopy for osteochondritis dissecans (OCD) of the capitellum, the literature on minimum 2-year clinical outcomes in a large cohort of patients is limited. We hypothesized that the clinical outcomes of patients treated arthroscopically for OCD of the capitellum would be favorable, with improved postoperative subjective functional and pain scores and with an acceptable return-to-play rate.
A retrospective analysis of a prospectively collected surgical database was performed to identify all patients treated surgically for OCD of the capitellum at our institution from January 2001 to August 2018. The inclusion criteria for this study included a diagnosis of OCD of the capitellum treated arthroscopically with a minimum 2-year follow-up period. The exclusion criteria included any prior surgical treatment on the ipsilateral elbow, missing operative reports, and cases in which any portion of the surgical procedure was performed in an open manner. Follow-up was performed by telephone using multiple patient-reported outcome questionnaires: American Shoulder and Elbow Surgeons-Elbow (ASES-e), Andrews-Carson, and Kerlan-Jobe Orthopaedic Clinic Shoulder and Elbow Score (KJOC) questionnaires and our institution-specific return-to-play questionnaire.
After the inclusion and exclusion criteria were applied to our surgical database, 107 eligible patients were identified. Of these, 90 were successfully contacted, for a follow-up rate of 84%. The mean age was 15.2 years, and the mean follow-up time was 8.3 years. A subsequent revision procedure was performed in 11 patients, for a 12% failure rate in these patients. The ASES-e pain score was an average of 4.0 on a maximum pain scale of 100, the ASES-e function score was an average of 34.5 of a maximum of 36, and the surgical satisfaction score was an average of 9.1 of 10. The average Andrews-Carson score was 87.1 of 100, and the average KJOC score for overhead athletes was 83.5 of 100. Additionally, of the 87 patients evaluated who played sports at the time of their arthroscopy, 81 (93%) returned to play.
This study demonstrated an excellent return-to-play rate and satisfactory subjective questionnaire scores with a 12% failure rate following arthroscopy for OCD of the capitellum with a minimum 2-year follow-up period.
虽然有许多研究评估了接受肘部关节镜检查治疗的肱骨滑车骨软骨病（OCD）患者的短期临床结果，但关于大量患者至少 2 年临床结果的文献有限。我们假设接受肘部关节镜治疗肱骨滑车 OCD 的患者的临床结果将是有利的，术后主观功能和疼痛评分将得到改善，并且重返赛场的比例是可以接受的。
对前瞻性收集的手术数据库进行回顾性分析，以确定 2001 年 1 月至 2018 年 8 月在我院接受手术治疗的肱骨滑车 OCD 患者。本研究的纳入标准包括接受肱骨滑车 OCD 关节镜治疗并至少随访 2 年的患者。排除标准包括同侧肘部有任何先前的手术治疗、手术报告缺失以及任何手术部分采用开放性手术的病例。通过电话使用多个患者报告的结果问卷进行随访：美国肩肘外科医师协会肘部（ASES-e）、Andrews-Carson 和 Kerlan-Jobe 骨科诊所肩部和肘部评分（KJOC）问卷以及我们机构特定的重返赛场问卷。
对我们的手术数据库应用纳入和排除标准后，确定了 107 名符合条件的患者。其中，有 90 名患者成功联系上，随访率为 84%。平均年龄为 15.2 岁，平均随访时间为 8.3 年。在这些患者中，有 11 名患者进行了后续翻修手术，失败率为 12%。ASES-e 疼痛评分平均为 100 分的 4.0 分，ASES-e 功能评分平均为 36 分的 34.5 分，手术满意度评分为 10 分的 9.1 分。Andrews-Carson 评分平均为 100 分的 87.1 分，从事过上肢运动的 KJOC 评分平均为 100 分的 83.5 分。此外，在 87 名接受关节镜检查时从事运动的患者中，81 名（93%）重返赛场。
这项研究表明，在接受至少 2 年随访的肘部关节镜治疗肱骨滑车 OCD 后，患者的重返赛场率较高，主观问卷评分令人满意，失败率为 12%。
