关节镜手术治疗肘关节重度骨性关节炎及关节强直

目的 探讨在关节镜下肘关节清理成形和软组织松解术治疗重度骨性关节炎及肘关节强直的临床疗效.方法 2005年3月至2009年10月,肘关节重度骨性关节炎患者34例,伴关节强直者13例.行关节镜下清理关节腔及游离体,对冠突、尺骨鹰嘴骨赘切除,冠突窝、鹰嘴窝、桡窝成形,对严重挛缩的关节囊和侧副韧带等给予必要的松解,术后指导康复训练,对比手术前后肘关节疼痛及伸屈活动度进行mayo评分.结果 34例患者肘关节的疼痛症状和活动度均有明显改善.其中13例肘关节强直者,术后伸直活动度增加(30±16)°,屈曲活动增加(34±19)°.手术前后肘关节最大ROM有差异统计学意义(P＜0.01).根据Mayo评分,34例总优良率85.3%.21例单纯骨性关节炎优良率为90.5%.结论 应用关节镜术治疗肘关节重度骨性关节炎及关节强直,创伤小、并发症少、疗效可靠.

Arthroscopic surgery for severe elbow osteoarthritis and ankylosis

Objective To investigate the clinical efficacy of arthroscopic debridement, shaping and soft tissue releasing in the treatment of severe elbow osteoarthritis and ankylosis. Methods Arthroscopies were performed in 34 patients with severe elbow osteoarthritis. Among them, 13 were accompanied by ankylosis. In arthroscopic surgery, articular cavity was cleared. And loose bodies, osteophytes of coronoid process and olecranon of ulna were excised, the corocoid fossa and olecranon fossa shaped and joint capsules and collateral ligments severely contracted properly released. Rehabilitation training was guided postoperatively. Arthralgia and range of motion of elbow were scored by Mayo's scoring criteria in contrast with that preoperatively. Results The pain and range of motion ( ROM ) of elbow improved obviously in 34 patients. Angle of extension postoperatively increased by 30°± 16°and angle of flexion increased by 34°±19°. Postoperative ROM of elbow show significant difference with the preoperative status ( P ＜ 0. 01 ).According to the Mayo's scoring criteria, the excellent and good rate was 85. 3%. Conclusion Arthroscopic treatment of severe osteoarthritis and ankylosis of elbow is reliable. Trauma of arthroscopy is minimal and complications are rare.