Schneider M M, Rentschler V, Geyer S, Jung C, Hollinger B, Pfalzer F, Beitzel K, Burkhart K, Schoch C
Praxisklinik Orthopädie Aachen (PKO), Germany.
University of Witten / Herdecke, Germany.
J Orthop. 2024 Nov 10;64:51-58. doi: 10.1016/j.jor.2024.10.061. eCollection 2025 Jun.
Elbow stiffness poses a significant challenge for surgeons as well as physiotherapists during and after surgery. To date, there is no consensus regarding the subsequent rehabilitation after surgical release of the stiff elbow.
The aim is to evaluate the most important therapeutic strategies following open or arthroscopic release of the stiff elbow based on a comprehensive literature review, and to develop a consensus for or against specific therapeutic methods with the help of a survey among elbow experts of the D-A-CH Association for Shoulder and Elbow Surgery (DVSE).
Literature search was performed based on guidelines, the "health technology assessments", systematic reviews and clinical studies that examined rehabilitation after osteocapsular release of the stiff elbow. The databases of the "Guidelines International Network", various national guidelines, PubMed, the "Cochrane Central Register of Controlled Trials", the "Cochrane Database of Systematic Reviews", and the "Physiotherapy Evidence Database" were scanned, each for the period from January 1989 to December 2019. As part of an online survey, all active members of the DVSE were asked about their strategies in immediate aftercare and rehabilitation after elbow arthrolysis.
A total of 5 reviews and 55 articles could be identified from 107 articles since 1989, which served as the basis for the preparation of an evidence-based aftercare recommendation. By reviewing all the mentioned paper and evaluation of the survery of DVSE members, a basic concept could be finalized.
肘关节僵硬在手术期间及术后给外科医生和物理治疗师都带来了重大挑战。迄今为止,对于僵硬肘关节手术松解后的后续康复尚无共识。
基于全面的文献综述,评估开放性或关节镜下松解僵硬肘关节后最重要的治疗策略,并借助对德国-奥地利-瑞士肩肘外科学会(DVSE)的肘关节专家进行的一项调查,就是否支持特定治疗方法达成共识。
根据指南、“卫生技术评估”、系统评价和临床研究进行文献检索,这些研究探讨了僵硬肘关节骨囊松解术后的康复情况。检索了“国际指南网络”数据库、各国的各种指南、PubMed、“Cochrane对照试验中心注册库”、“Cochrane系统评价数据库”和“物理治疗证据数据库”,检索时间均为1989年1月至2019年12月。作为在线调查的一部分,向DVSE的所有活跃成员询问了他们在肘关节松解术后即时护理和康复方面的策略。
自1989年以来,从107篇文章中总共识别出5篇综述和55篇文章,这些作为制定循证性术后护理建议的基础。通过回顾所有上述论文并评估DVSE成员的调查结果,最终确定了一个基本概念。