Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Department of Orthopedic Surgery, Uijeongbu Eulji Medical Center, Eulji University College of Medicine, Uijeongbu-si, Republic of Korea.
Am J Sports Med. 2023 Jul;51(8):2050-2056. doi: 10.1177/03635465231171542. Epub 2023 May 22.
Arthroscopic osteocapsular arthroplasty (OCA) achieves significant medium-term outcomes in patients with primary elbow osteoarthritis (OA); however, outcomes after revision arthroscopic OCA are not well known.
To assess clinical outcomes after revision arthroscopic OCA as compared with those after primary surgery in patients with OA.
Cohort study; Level of evidence, 3.
Patients who underwent arthroscopic OCA attributed to primary elbow OA between January 2010 and July 2020 were enrolled. Range of motion (ROM), visual analog scale (VAS) pain score, and Mayo Elbow Performance Score (MEPS) were assessed. Operation time and complications were assessed by chart review. Clinical outcomes between the primary and revision surgery groups were compared, and subgroup analysis for radiologically severe OA was performed.
Data from 61 patients were analyzed (primary, n = 53; revision, n = 8). The mean ± SD age was 56.3 ± 8.5 and 54.3 ± 8.9 years in the primary and revision groups, respectively. The primary group had significantly better ROM arcs preoperatively (89.9°± 20.3° vs 71.3°± 22.3°; = .021) and postoperatively (112.4°± 17.1° vs 96.9°± 16.5°; = .019) than the revision group; however, the degree of improvement was comparable ( = .445). Postoperative VAS pain score ( = .164) and MEPS ( = .581) were comparable between the groups, as were the degrees of improvement in VAS pain score ( = .691) and MEPS ( = .604). The revision group required a significantly longer operative time than the primary group ( = .004) and had a nonsignificant higher complication rate ( = .065). Subgroup analysis showed that radiologically severe cases in the primary group had significantly better preoperative ( = .010) and postoperative ( = .030) ROM arcs than the revision group and a comparable postoperative VAS pain score ( = .155) and MEPS ( = .658).
Revision arthroscopic OCA is a favorable treatment option for primary elbow OA with recurrent symptoms. Postoperative ROM arc was worse after revision surgery as compared with primary surgery; however, the degree of improvement was comparable. Postoperative VAS pain score and MEPS were comparable with primary surgery.
关节镜下骨囊关节成形术（OCA）可显著改善原发性肘关节炎（OA）患者的中期疗效，但关节镜下 OCA 翻修后的疗效尚不清楚。
评估原发性 OA 患者行关节镜下 OCA 翻修与初次手术的临床疗效。
队列研究；证据水平，3 级。
纳入 2010 年 1 月至 2020 年 7 月间因原发性肘 OA 行关节镜下 OCA 的患者。评估患者的关节活动度（ROM）、视觉模拟评分（VAS）疼痛评分和 Mayo 肘功能评分（MEPS）。通过病历回顾评估手术时间和并发症。比较初次手术组和翻修手术组的临床疗效，并对影像学重度 OA 进行亚组分析。
共分析了 61 例患者的数据（初次手术组 53 例，翻修手术组 8 例）。初次手术组和翻修手术组患者的平均年龄分别为 56.3±8.5 岁和 54.3±8.9 岁。初次手术组患者术前（89.9°±20.3°比 71.3°±22.3°； =.021）和术后（112.4°±17.1°比 96.9°±16.5°； =.019）ROM 弧明显更大，但两组术后改善程度相当（ =.445）。术后 VAS 疼痛评分（ =.164）和 MEPS（ =.581）无显著差异，VAS 疼痛评分（ =.691）和 MEPS（ =.604）改善程度也相当。翻修手术组的手术时间明显长于初次手术组（ =.004），并发症发生率虽高但无统计学差异（ =.065）。亚组分析显示，初次手术组影像学重度 OA 患者术前（ =.010）和术后（ =.030）ROM 弧明显大于翻修手术组，术后 VAS 疼痛评分（ =.155）和 MEPS（ =.658）相当。
对于有复发性症状的原发性肘 OA，关节镜下 OCA 翻修是一种可行的治疗方法。与初次手术相比，翻修术后的 ROM 弧更差，但改善程度相当。术后 VAS 疼痛评分和 MEPS 与初次手术相当。
