残留内侧骨赘对肱骨尺置换术后预后的影响

S. Nobuta, Katsumi Sato, E. Itoi
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摘要

目的:报道尺骨关节置换术治疗症状性肘关节骨性关节炎的远期疗效。UHA不允许进入内侧肱骨尺骨赘和放射肱骨关节,残留的内侧肱骨尺骨赘对结果的影响尚不清楚。本研究的目的是在更大的样本量中确定残留的内侧骨赘对结果的影响。方法:对51例肘关节骨性关节炎患者的58个肘关节行UHA治疗并进行评价。术前,所有患者均有运动疼痛和肘关节屈伸弧度丧失的症状。术前评估和随访结果采用Mayo肘关节功能评分(MEPS)进行评估,正位x线片评估内侧尺骨骨赘。结果:41例肘部无疼痛感,17例肘部疼痛减轻。平均屈伸弧度从术前的93°提高到术后的107°。总MEPS从69提高到91。结果:40例肘部为优(69%),14例为好(24%),4例为一般(7%),无不良病例。患者满意度:主观结果满意50例(86%),不满意8例(14%)。术前屈伸弧度是预测术后结果的因素。内侧尺骨骨赘与屈伸弧度降低有关,但与患者满意度和疼痛程度无关。结论:内侧尺骨骨赘的残留与UHA后屈伸弧度的降低有关,但与患者满意度和疼痛程度无关。
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Influence of Remained Medial Osteophyte on the Outcome after Ulnohumeral Arthroplasty
Objective: The authors reported the long-term results of ulnohumeral arthroplasty (UHA) for symptomatic elbow osteoarthritis. UHA does not allow access to the medial ulnohumeral osteophyte and to the radiohumeral joint, and the influence of remained medial ulnohumeral osteophyte on the outcome is still unclear. The purpose of the present study was to determine the influence of remained medial osteophyte on the outcome in a much larger sample size. Methods: Fifty-eight elbows in 51 patients with elbow osteoarthritis underwent UHA and were evaluated. Before surgery, all patients complained of motion pain and loss of flexion-extension arc of the elbow. Preoperative evaluation and the outcome at follow-up were assessed using Mayo Elbow Performance Score (MEPS), and medial ulnohumeral osteophyte was assessed in anteroposterior radiograph. Results: Forty-one elbows had no pain and 17 decreased pain. The average flexion-extension arc improved from 93° preoperatively to 107°postoperatively. Total MEPS improved from 69 to 91. The result was excellent for 40 elbows (69%), good for 14 (24%), fair for four (7%) and no poor case. Patients’ satisfaction showed that fifty (86%) were satisfactory subjective result and eight (14%) were unsatisfactory result. The preoperative flexion-extension arc was factors for predicting postoperative results. Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale. Conclusions: Remained medial ulnohumeral osteophyte was related to decreased arc of the flexion-extension but not patients’ satisfaction and pain scale after UHA.
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