髌骨骨软骨软化症的矢状面计算机断层扫描评估与青少年棒球运动员关节镜清创术的临床效果相关。

IF 2.7 Q1 ORTHOPEDICS Journal of ISAKOS Joint Disorders & Orthopaedic Sports Medicine Pub Date : 2024-08-20 DOI:10.1016/j.jisako.2024.07.009

Kenji Yokoyama , Tetsuya Matsuura , Joji Iwase , Toshiyuki Iwame , Koichi Sairyo

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引用次数: 0

摘要

研究目的研究冠状位和矢状位重建计算机断层扫描（CT）图像上测量的帽状腱膜骨软骨松解症（OCD）骨软骨缺损的大小和位置与青少年棒球运动员关节镜清创术临床疗效之间的关系：这项回顾性研究调查了 2008 年至 2020 年间手术后随访时间≥ 24 个月的青少年棒球运动员关节镜清创治疗帽状腱膜 OCD 的临床效果。在术前冠状 CT 图像上，内侧和外侧距离（%）用于评估缺损位置。同时还评估了缺损大小（%）。在术前的矢状 CT 图像上，上角和下角（度）用于评估缺损的位置。用缺损角度（度）评估缺损大小。在最近一次随访时，采用 Timmerman-Andrews 评分来确定结果。斯皮尔曼等级相关系数用于检验这些参数与 Timmerman-Andrews 评分之间的关系。统计显著性以 p < 0.05 为标准：30名球员（平均年龄14岁[11-16岁]）接受了关节镜清创术：其中投手 5 人，接球手 7 人，内野手 13 人，外野手 5 人。平均随访时间为 26 个月（24-66 个月）。最近一次随访的 Timmerman-Andrews 评分中位数为 193 分（IQR，181-200 分）。下角与 Timmerman-Andrews 评分（rs = 0.520，p < 0.01）、疼痛（rs = 0.478，p < 0.01）和矢状运动弧（rs = 0.409，p = 0.025）呈显著正相关。缺损角度与 Timmerman-Andrews 评分（rs = -0.462，p = 0.010）和屈曲挛缩（rs =-0.424，p = 0.020）呈统计学意义上的显著负相关。内侧距离、外侧距离、缺损大小和上角与 Timmerman-Andrews 评分或其任何子评分均无相关性：结论：术前矢状CT图像显示的肱骨髌骨后方或大块骨软骨缺损会影响青少年棒球运动员髌骨OCD关节镜清创术的效果：证据级别：V级，病例系列。

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Sagittal computed tomography evaluation of osteochondritis dissecans of the capitellum correlates with clinical outcomes of arthroscopic debridement in adolescent baseball players

Objectives

To investigate the relationship between the size and location of osteochondral defects in capitellar osteochondritis dissecans (OCD) measured on coronal and sagittal reconstructed computed tomography (CT) images and the clinical outcomes of arthroscopic debridement in adolescent baseball players.

Methods

This retrospective study investigated the clinical outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players with ≥24 months of follow-up after surgery between 2008 and 2020. On preoperative coronal CT images, medial and lateral distance (%) were used to evaluate the location of the defect. Defect size (%) was also evaluated. On preoperative sagittal CT images, superior and inferior angles (deg) were used to evaluate the location of the defect. The size of the defect was evaluated using the defect angle (deg). Outcome measures were determined using the Timmerman–Andrews score at the latest follow-up. Spearman’s rank correlation coefficient was used to examine relationships between these parameters and the Timmerman–Andrews score. Statistical significance was set at p < 0.05.

Results

Thirty players [mean age, 14 (range, 11–16) years] underwent arthroscopic debridement: 5 were pitchers, 7 were catchers, 13 were infielders, and 5 were outfielders. Mean follow-up duration was 26 (range, 24–66) months. The median Timmerman–Andrews score at the latest follow-up was 193 [interquartile range (IQR), 181–200] points. Inferior angle showed statistically significant positive correlations with Timmerman–Andrews score (r_s = 0.520, p < 0.01), pain (r_s = 0.478, p < 0.01), and sagittal arc of motion (r_s = 0.409, p = 0.025). Defect angle showed statistically significant negative correlations with Timmerman–Andrews score (r_s = −0.462, p = 0.010) and flexion contracture (r_s = -0.424, p = 0.020). Medial distance, lateral distance, defect size, and superior angle were not correlated with the Timmerman–Andrews score or any of its subscores.

Conclusion

Posterior or large osteochondral defects of the humeral capitellum on preoperative sagittal CT images affected the outcomes of arthroscopic debridement for capitellar OCD in adolescent baseball players.