肘关节镜下清理术治疗肘关节骨关节炎的早期疗效

目的探讨肘关节镜下清理术治疗肘关节骨关节炎的早期疗效以及术中第一入路的选择。方法2010年5月至2013年5月,我院收治16例肘关节骨关节炎患者,男14例,女2例;年龄22-58岁,平均45岁。右肘15例、左肘1例,均单侧发病。采用侧卧位,以后正中入路作为第一入路,辅以后外侧和近端内、外侧入路行肘关节镜下清理术。分别测量术前、术后肘关节伸直角度、屈曲角度、活动度,应用Mayo肘关节功能评分（Mayo elbow performance score,MEPS）评价疗效。结果所有患者均获随访,切口均甲级愈合,无神经及血管损伤并发症。肘关节伸直角度、屈曲角度、活动度及MEPS值较术前明显改善（P〈0.05）。术后MEPS值结果：优9例,良4例,中3例,优良率达81.25%。结论肘关节镜下清理术治疗肘关节骨关节炎,可以明显增加关节活动度,改善关节功能,早期疗效较好。采用侧卧位,以后正中入路作为第一入路,辅以后外侧和近端内、外侧入路,术中操作方便,安全。

Short-term outcome of elbow debridement under arthroscopy in patients with elbow osteoarthritis

Objective To evaluate the short-term outcome of elbow debridement under arthroscopy in patients with elbow osteoarthritis and the choice of the first approach during the operation.Methods Between May2010 and May 2013,there were 16 cases of elbow osteoarthritis（14 males,and 2 females）.The average age was45 years old（range：22-58 years）.Fifteen cases were affected with right side,and1 case with left side.The lateral position was used.Posterior median approach was used as the first one.The posterolateral approach,the proximal medial approach and the proximal lateral approach were used to perform the elbow debridement under arthroscope.Elbow extension angle,flexion angle,and range of motion were measured before and after operation.Mayo Elbow Performance Score（MEPS）was used to evaluate the therapeutic effect.Results All the patients were followed up.All incisions healed by first intention.There were no complications of nerve and blood vessel injury.The elbow extension angle,flexion angle,range of motion and MEPS were significantly increased after operation as compared with those before operation（P〈0.05）.At the end of the follow-up period,the MEPS results showed：excellent in 9 cases,good in4 cases,and fair in3 cases.The excellent and good rate was 81.25%.Conclusion The arthroscopic debridement is an effective technique to treat the patients with elbow osteoarthritis,which can obviously increase the range of motion and improve the function of elbow joint,and has good short-term outcomes.The operation is convenient and safe in lateral position,with posterior median approach as the first approach,combined with the posterolateral approach,the proximal medial approach and the proximal lateral approach.