Hall Anya T, Paul Ryan W, Lencer Adam, Smith Brandon, Ciccotti Michael G, Tjoumakaris Fotios P, Erickson Brandon J
Rothman Orthopaedic Institute, New York, New York, USA.
Orthop J Sports Med. 2023 Aug 17;11(8):23259671231190381. doi: 10.1177/23259671231190381. eCollection 2023 Aug.
Elbow capsular release can be performed arthroscopically or through an open method to improve range of motion (ROM). However, it is unclear how frequently patients require an open capsular release after unsatisfactory results from an arthroscopic release.
PURPOSE/HYPOTHESIS: The purpose of this study was to determine the percentage of patients who underwent an arthroscopic elbow release for loss of motion who then required a repeat elbow capsular release or other subsequent surgery on the same elbow. It was hypothesized that patients who underwent arthroscopic elbow release would rarely (<5%) require a subsequent elbow release.
Case series; Level of evidence, 4.
Patients who underwent arthroscopic elbow capsular release from January 1, 2010, to December 31, 2019, were identified by chart review and procedure code. Demographic parameters, pre- and postoperative ROM, and surgical history were collected by chart review. Follow-up data included patient satisfaction and the Timmerman-Andrews (TA) elbow score. Data were compared between patients who did and those who did not require subsequent elbow surgery.
Overall, of 140 study patients (116 male, 24 female; mean age, 49.6 years), 18 (12.9%) required subsequent surgery, including 6 capsular releases (4.3%; 1 open and 5 arthroscopic). The most common follow-up procedure was ulnar nerve releases/transpositions (n = 7). Total arc of elbow motion (flexion to extension) improved by a mean of 51.4°. The mean TA score was 76.5 ± 20.4 at a mean of 5.25 years postoperatively. Mean satisfaction score was 77.6 ± 26.3. In this study, 82.4% of patients stated that their symptoms either improved or resolved completely. Patients who required subsequent surgery had a significantly lower preoperative total arc of elbow motion versus those who did not require subsequent surgery ( = .046). There was no difference between the groups in symptom resolution, satisfaction, ROM, or TA score ( ≥ .279 for all).
After arthroscopic elbow release, <5% of patients required a repeat elbow capsular release, 12.9% required some form of follow-up elbow surgery, and 4.3% had a new injury of the elbow. Overall, patients saw improvement in elbow ROM, but many still had residual symptoms from their underlying disease after arthroscopic elbow capsular release.
肘关节囊松解术可通过关节镜或开放手术进行，以改善活动范围（ROM）。然而，在关节镜松解术效果不理想后，患者需要进行开放囊松解术的频率尚不清楚。
目的/假设：本研究的目的是确定因活动受限接受关节镜下肘关节松解术的患者中，需要再次进行肘关节囊松解术或在同一肘部进行其他后续手术的患者百分比。假设接受关节镜下肘关节松解术的患者很少（<5%）需要后续的肘关节松解术。
病例系列；证据等级，4级。
通过病历审查和手术编码确定2010年1月1日至2019年12月31日期间接受关节镜下肘关节囊松解术的患者。通过病历审查收集人口统计学参数、术前和术后的ROM以及手术史。随访数据包括患者满意度和Timmerman-Andrews（TA）肘关节评分。对需要和不需要后续肘关节手术的患者的数据进行比较。
总体而言，140例研究患者（116例男性，24例女性；平均年龄49.6岁）中，18例（12.9%）需要后续手术，包括6例囊松解术（4.3%；1例开放手术和5例关节镜手术）。最常见的后续手术是尺神经松解/移位术（n = 7）。肘关节活动总弧（屈曲至伸展）平均改善了51.4°。术后平均5.25年时，平均TA评分为76.5±20.4。平均满意度评分为77.6±26.3。在本研究中，82.4%的患者表示其症状有所改善或完全缓解。需要后续手术的患者术前肘关节活动总弧明显低于不需要后续手术的患者（P = .046）。两组在症状缓解、满意度、ROM或TA评分方面无差异（所有P≥.279）。
关节镜下肘关节松解术后，<5%的患者需要再次进行肘关节囊松解术，12.9%的患者需要某种形式的后续肘关节手术，4.3%的患者出现了新的肘部损伤。总体而言，患者的肘关节ROM有所改善，但许多患者在关节镜下肘关节囊松解术后仍有潜在疾病的残留症状。
