关节镜下关节成形术治疗中期原发性肘关节骨关节炎疗效分析

The curative effect analysis of treatment of arthroplasty using arthroscopy for medium-term primary elbow osteoarthritis

目的 探讨关节镜下关节成形术治疗中期肘关节骨关节炎（OA）手术方法并总结其疗效。方法 回顾分析2011年8月至2014年8月接受关节镜下关节成形术原发性肘关节OA患者共42例,其中31例获得随访。比较术前、术后3、6、12个月随访时的肘关节运动范围（ROM）、Mayo肘关节功能评分（MEPS）、视觉疼痛评分（VAS）,以评估其疗效。结果31例获平均14.5个月随访（随访时间12-18个月）。术后3个月VAS较术前降低,差异有统计学意义（P〈0.05）;与术后6、12个月比较差异无统计学意义（P〉0.05）。末次随访24例患者达到无痛状态。术后3个月ROM、MEPS比术前提高,差异有统计学意义（P〈0.05）。术后6个月ROM、MEPS相对于术后3个月仍有提高,差异有统计学意义（P〈0.05）,但与术后12个月比较差异无统计学意义（P〉0.05）。末次随访MEPS评定优20例,良8例,中2例,差1例,优良率90.3%。结论 关节镜下关节成形术治疗中期原发性肘关节OA可以有效缓解疼痛和改善关节功能,严格把握手术适应证和规范的康复训练是关键环节。

Objective To explore the curative effect of arthroplasty using arthroscopy for diagnosis and treatment of medi- um-term elbow osteoarthritis（OA）. Methods Forty-two patients with OA from August 2011 to August 2014 were retrospectively analyzed. Thirty-one cases underwent follow-up. The preoperative and postoperative elbow range of motion （ROM）, Mayo elbow performance score（MEPS）,visual pare score （VAS） at 3,6,12 months after, surgery were compared,and the curative effect was e- valuated. Results Thirty-one cases underwent average of 14. 5 months（12 to 18 months） follow-up. VAS score reduced with statis- tically significant at 3 months postoperatively（P〈0. 05）, and there was no difference in 6 months and 1 year compared to preopera- tion（P〉0.05） ;24 patients achieved normal state at the last follow-up. ROM and MEPS scores in 3 months after operation were higher than those before operation, with statistically significant （P〈 0. 05）. ROM, MEPS scores were still improving after six months of surgery,and the difference was statistically significant（P〈0. 05）,but there was no difference at 12 months after opera- tion（P〉0.05）. The excellent and good rate was 90.3% by using MEPS functional assessment at the last follow-up,including ex- cellent for 20 cases,good for 8 cases.fair for 2 cases,poor for 1 case. Conclusion Using arthroscope to treat medium-term primary elbow joint osteoarthritis can effectively relieve pain and improve joint function. The key process is strictly controlling the operation indication and combining with postoperative rehabilitation.