关节镜监视下等离子刀射频治疗顽固性肱骨外上髁炎的疗效观察

Efficacy of arthroscopic guided radiofrequency thermoablation for refractory lateral epicondylitis:report of 38 cases

目的 探讨关节镜监视下微创治疗肱骨外上髁炎的疗效。方法 选取2010年1月至2014年12月期间解放军总医院骨科收治的行关节镜监视下等离子刀（TOPAZ）射频治疗的顽固性肱骨外上髁炎患者38例。采用术前、术后疼痛视觉模拟量表（VAS）评分及Mayo12点评分评价手术效果。疗效观察采用尼莫地平法。随访12个月以上。结果 所有患者手术均顺利完成，术中及术后未见血管神经损伤，自述疼痛症状及活动受限程度较术前减轻。与术前相比，患者术后12个月的VAS评分［（7.05±0.80） vs （2.47±1.36）分］和Mayo12点评分［（32.66±6.38） vs （13.18±8.44）分］都得到了显著改善，差异均具有统计学意义（P＜0.05）。12个月后的总有效率达94.7%。结论 关节镜监视下TOPAZ射频治疗慢性肱骨外上髁炎疗效确切，操作简便、创伤小，并发症少。

Objective To evaluate therapeutic effect of a minimal invasive operation guided by arthroscopy in treatment of lateral epicondylitis. Methods A total of 38 patients with refractory lateral epicondylitis treated in our department from January 2010 to December 2014 were enrolled in this study. They received TOPAZ treatment under the guide of arthroscopy. Visual analogue scale （VAS） for pain and Mayo elbow performance scores before and after operation were used to assess the effect of the operation. Nimodipine method was adopted to evaluate the efficiency. All the patients were followed up for more than 12 months. Results All the patients were operated successfully, and no vessel or nerve injury was observed intra-and post-operatively. All of them reported alleviation of pain and activity limitation. Great improvements were made in the VAS score（7.05±0.80 vs 2.47±1.36） and Mayo elbow function score （32.66±6.38 vs 13.18±8.44） in 12 months after treatment （both P〈0.05）. The total efficiency was 94.74% at the end of follow-up in the cohort. Conclusion Arthroscopic guided radiofrequency thermoablation （TOPAZ） is simple, effective, less invasive, and of fewer complications in the treatment of chronic lateral epicondylitis.