关节镜下治疗肘关节骨性关节炎伴僵硬短期疗效观察

目的探讨肘关节镜下治疗肘关节骨性关节炎伴关节僵硬的临床疗效。 方法回顾性分析2015年5月至2018年6月期间于乌海市人民医院收治肘关节骨性关节炎伴肘关节僵硬的患者17例，所有患者均肘关节镜下行滑膜骨赘清理、关节囊松解、游离体取出、关节结构成型，术后均行专业康复功能训练，观察比较围手术期前、后肘关节视觉模拟评分（visual analogue scale,VAS）、关节活动度、肘关节功能Mayo评分和美国特种外科医院膝关节评分（hospital for special surgery knee score,HSS）的差异，评价其临床疗效。 结果术后均无神经血管损伤、肘关节副韧带损伤、切口愈合不良、感染、异位骨化等术后并发症的发生。所有患者在术后12个月随访时进行评估，VAS评分术前（6.17±1.07）分，术后（2.94±0.65）分；肘关节Mayo评分术前（44.41±3.42）分，术后（93.23±1.71）分；HSS评分术前（45.29±6.69）分，术后（88.41±2.59）分，差异均有统计学意义；术后关节屈伸及旋转活动度显著改善。 结论应用关节镜技术治疗肘关节骨性关节炎伴肘关节僵硬能够显著改善肘关节功能，具有创伤小、恢复快、疗效可靠等优点。

Short-term efficacy observation of arthroscopy in the treatment of elbow joint osteoarthritis with stiffness

BackgroundThe elbow joint is one of the flexible and complex joints of the human body. It has the function of extension and flexion, and its damage will seriously affect the function of hand and forearm, and greatly reduce the quality of life. There are auxiliary ligaments around the elbow joint, and the joint is tightly matched. The elbow joint injury will induce inflammatory reactions (e.g. osteoarthritis) , resulting in the adhesion joint capsule and surrounding tissue and thus increasing the incidence of stiffness and rigidity. Previous studies have shown that the incidence of post-traumatic elbow stiffness is about 16% to 40%, and its incidence increases with the severity of fractures. Due to the narrow space and complicated structures of the elbow joint cavity, there are many nerves and vessels around, which make the difficulty and risk of surgery increase. Conventional elbow joint open release and debridement surgery are more traumatic and difficult for rehabilitation training, and the postoperative effects are uneven. Objective To investigate the clinical efficacy of elbow arthroscopy in the treatment of elbow osteoarthritis with joint stiffness. MethodsFrom May 2015 to June 2018, a retrospective analysis of 17 patients with elbow joint osteoarthritis and stiffness in our hospital was performed. All patients received synovial osteophyte cleaning, capsule release, free body removal and joint structure arthroplasty, and the professional rehabilitation was performed after operation. The VAS score, range of motion, Mayo score and HSS score were observed and compared in the perioperative period for the assessment of clinical efficacy. ResultsThere were no postoperative complications such as neurovascular injury, elbow collateral ligament injury, poor postoperative incision healing, infection and heterotopic ossifications. All patients were followed up for 12 months after operation. The preoperative VAS score was (6.17±1.07) points and the postoperative VAS score was (2.94±0.65) points. The preoperative Mayo score was (44.41±3.42) points and the postoperative Mayo score was (93.23±1.71) points. The preoperative HSS score was (45.29±6.69) points and the postoperative HSS score was (88.41±2.59) points. There were significant differences in these scores. The postoperative range of flexion and extension as well as rotation was significantly improved. ConclusionArthroscopic technique for treatment of elbow osteoarthritis with elbow joint stiffness can significantly improve elbow joint function with the advantages of minimal trauma, quick recovery and reliable efficacy.