Tratamiento artroscópico versus tratamiento mediante cirugía abierta de la epicondilitis lateral. Estudio de cohortes prospectivo

Vicente Carratalá , Francisco Javier Lucas , Ignacio Miranda , Javier Ignacio Ortego , Eduardo Sánchez-Alepuz
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引用次数: 2

Abstract

Purpose

To compare the results between arthroscopic and open surgery in the treatment of lateral epicondylitis.

Methods

A prospective cohort study was conducted on 30 patients treated with lateral epicondylitis, in which rehabilitation treatment during 3 months had failed. They were distributed into 2 groups: open surgery and arthroscopic surgery.

Results

The mean age of the patients was 47.63 ± 1.19, 17 women and 13 men, with a mean follow-up time of 69.07 ± 4.01 days. Preoperative pain (visual analogue scale (VAS) 9.27 ± 0.12) decreased (p < .001) with both techniques a week after surgery (7,33 ± 0,25 in open surgery and 3.40 ± 0.21 in arthroscopic) and at the time of discharge (2.00 ± 0.20 in open surgery and 1.33 ± 0.16 in arthroscopic), this decline being significantly higher one week after surgery (p < .001), and at the time of discharge (p = .03) in arthroscopic surgery than in open surgery. Pre-operative functionality (Mayo Elbow Performance Score (MEPS) 45.00 ± 0.98 in open surgery and 44.00 ± 0.87 in arthroscopic surgery) significantly improved (p < .001) in both groups after surgery (87.67 ± 1.45 in open surgery and 90.33 ± 1.98 in arthroscopic surgery), with no significant differences between the two groups. The time to discharge for the return to work activity was significantly lower (p = .004) in arthroscopic surgery (58.87 ± 4.15 days) than in open surgery (79.27 ± 5.88 days).

Conclusions

In patients with lateral epicondylitis, pain and functionality improved with both techniques. Relief of pain was greater with arthroscopic surgery than with open surgery, with no significant differences in functionality scores at the time of discharge between the two groups. Post-operative time to discharge was significantly lower with arthroscopic surgery than with open surgery.

Level of evidence

II.

Clinical relevance

Arthroscopic surgery of lateral epicondylitis achieves as good functional results, but with less pain, and also an earlier return to work activity than open surgery.

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关节镜治疗与开放手术治疗外侧上髁炎。前瞻性队列研究
目的比较关节镜和开放手术治疗外上髁炎的疗效。方法对30例侧上髁炎患者进行前瞻性队列研究,其中3个月的康复治疗失败。他们被分为两组:开放手术组和关节镜手术组。结果患者平均年龄47.63±1.19,女性17例,男性13例,平均随访时间69.07±4.01天。术前疼痛(视觉模拟评分(VAS)9.27±0.12)在术后一周(公开手术中为7.33±0.25,关节镜下为3.40±0.21)和出院时(公开手术为2.00±0.20,关节镜下1.33±0.16)均有所下降(p<0.001),手术后一周这种下降明显更高(p<.001),在关节镜手术中出院时(p=.03)比在开放手术中。术后两组的术前功能(Mayo肘关节功能评分(MEPS)在开放手术中为45.00±0.98,在关节镜手术中为44.00±0.87)均显著改善(p<0.001)(开放手术为87.67±1.45,关节镜手术为90.33±1.98),两组之间无显著差异。关节镜手术(58.87±4.15天)比开放手术(79.27±5.88天)明显缩短了重返工作岗位的出院时间(p=0.004)。关节镜手术比开放手术更能缓解疼痛,两组出院时的功能评分没有显著差异。关节镜手术的术后出院时间明显低于开放手术。证据水平II.临床相关性侧上髁炎的关节镜手术取得了同样好的功能效果,但疼痛较少,而且比开放手术更早恢复工作。
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