Chen Renjie, Yang Guang, Li Shangzhe, Deng Haoyuan, Zhang Hailong, Lu Yi
Sports Medicine Department, Beijing Jishuitan Hospital, Capital Medical University, No. 31, Xin Jie Kou Dong Street, Xi Cheng District, Beijing, 100035, China.
J Orthop Surg Res. 2025 Jul 28;20(1):714. doi: 10.1186/s13018-025-06145-9.
Osteophytes in elbow osteoarthritis (OA) patients can lead to limited range of motion (ROM) and functional deficiency. However, few studies have described the osteophytes distribution and the distribution of osteophytes in elbow OA patients with different ROM and functional grades has not been studied. This study aimed to develop a classification system of elbow osteophytes based on bony landmarks to describe the location of osteophytes in patients with elbow OA, and explore whether there are differences in the incidence of osteophytes at different locations in OA patients with different elbow ROM and function scores stage.
97 elbow OA patients with preoperative three dimensional computed tomograph (3D-CT) were enrolled in this retrospective study. 3D-CT of elbow joint were collected from database and the joint was divided into 11 regions, and patients were classified into three different groups according to the Qian's ROM classification or Mayo Elbow Performance Score (MEPS) separately. The independent t-test or one-way analysis of variance was used to compare continuous variables between groups, and chi-square test was used to compare categorical variables. The intraobserver reliability and interobserver reliability of the new classification system was calculated by the Cohen kappa statistic.
Osteophytes are most commonly found in the olecranon (93%). There were significant differences between different ROM (P < 0.001) and MEPS (P < 0.001) groups in the incidence of osteophytes in the dorsal aspect of the capitellum (region 7). Patients without osteophytes in region 7 had larger ROM (81 ± 31° vs. 65 ± 28°, P = 0.009) than those with osteophytes, and better MEPS scores (79.0 ± 15.8 vs. 69.5 ± 18.5, P = 0.007). The interobserver agreement values for the osteophytes location was 0.894 (P < 0.001); and the intraobserver agreement values for the osteophytes location was 0.908 (P < 0.001).
The bony landmarks classification system effectively delineated osteophyte distribution in elbow patients. In elbow OA patients, the olecranon is the area with the highest incidence of osteophytes. Osteophytes at the dorsal aspect of the capitellum significantly affected both elbow ROM and MEPS.
肘关节骨关节炎（OA）患者的骨赘可导致活动范围（ROM）受限和功能缺陷。然而，很少有研究描述骨赘的分布，且尚未研究不同ROM和功能分级的肘关节OA患者中骨赘的分布情况。本研究旨在基于骨性标志开发一种肘关节骨赘分类系统，以描述肘关节OA患者骨赘的位置，并探讨不同肘关节ROM和功能评分阶段的OA患者不同位置骨赘的发生率是否存在差异。
本回顾性研究纳入了97例术前行三维计算机断层扫描（3D-CT）的肘关节OA患者。从数据库中收集肘关节的3D-CT图像，并将关节分为11个区域，患者分别根据钱氏ROM分类或梅奥肘关节功能评分（MEPS）分为三个不同组。采用独立t检验或单因素方差分析比较组间连续变量，采用卡方检验比较分类变量。通过Cohen kappa统计量计算新分类系统的观察者间信度和观察者内信度。
骨赘最常见于尺骨鹰嘴（93%）。在不同ROM组（P＜0.001）和MEPS组（P＜0.001）中，肱骨小头背侧（区域7）骨赘的发生率存在显著差异。区域7无骨赘的患者比有骨赘的患者具有更大的ROM（81±31°对65±28°，P = 0.009）和更好的MEPS评分（79.0±15.8对69.5±18.5，P = 0.007）。骨赘位置的观察者间一致性值为0.894（P＜0.001）；骨赘位置的观察者内一致性值为0.908（P＜0.001）。
骨性标志分类系统有效地描绘了肘关节患者骨赘的分布。在肘关节OA患者中，尺骨鹰嘴是骨赘发生率最高的区域。肱骨小头背侧的骨赘显著影响肘关节ROM和MEPS。
