Anterior Capsulectomy Through Humeral Fenestration in Arthroscopic Arthrolysis for Elbow Stiffness Is Safe and Effective

Q3 Medicine
Clémence Lemaître , Antoine Senioris M.D. , Fabrice Duparc M.D., Ph.D.
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引用次数: 0

Abstract

Purpose

To evaluate arc of motion and complications following transhumeral anterior capsulectomy through a purely posterior approach with the Outerbridge-Kashiwagi procedure in treating elbow stiffness.

Methods

Patients who were treated for elbow stiffness between April 2003 and February 2023 were retrospectively identified. The inclusion criteria were an extension/flexion arc deficit of at least 30° and treatment with arthroscopic arthrolysis through posterior and posterolateral portals with humeral fenestration. Elbow joint range of motion and the Mayo Elbow Performance Score were assessed preoperatively, intraoperatively, at 6 weeks, and at final follow-up. The follow-up ended when the elbow became asymptomatic again or when the recovery was considered stable. Postoperative complications were recorded.

Results

A total of 30 patients (23 men/7 women; 31 elbows; 1 bilateral/29 unilateral) were included. Mean follow-up was 11.1 months (1-64). Mean joint amplitudes intraoperatively increased in all areas of mobility, including extension/flexion from 86° to 132.6° (P = .001) and pronation/supination from 163.9° to 179.7° (P = .025). At the longest follow-up, mean joint amplitude was increased from 86° to 118.9° (P = .002) in extension/flexion and from 136.9° to 173.9° (P = .022) in pronation/supination. The mean deficit was reduced from 54° to 21.1° (P = .001) in extension/flexion and from 16.1° to 6.1° (P = .006) in pronation/supination. The mean gain in the extension/flexion arc was 31.5° and 10° for the pronation/supination arc. Loss in flexion/extension was limited (mean: 14.2°, extreme: 50°). The study showed no neurologic complications.

Conclusions

Arthroscopic arthrolysis of a stiff elbow using a purely posterior approach with anterior capsulectomy via the Outerbridge-Kashiwagi procedure was safe and effective. Clinical results showed improvement in joint range of motion in flexion/extension and pronation/supination, both intraoperatively and postoperatively, with no postoperative neurologic complications.

Level of Evidence

Level IV, therapeutic case series.
经肱骨开窗前囊切除术治疗关节镜下肘关节僵硬安全有效
目的评价纯后路经肱骨前囊切除术联合Outerbridge-Kashiwagi手术治疗肘关节僵硬后的活动弧度及并发症。方法回顾性分析2003年4月至2023年2月间因肘关节僵硬接受治疗的患者。纳入标准为至少30°的伸/屈弧度缺陷,并通过肱骨开窗的后外侧和后外侧门静脉进行关节镜下关节松解。术前、术中、6周及最终随访时评估肘关节活动范围和Mayo肘关节功能评分。当肘部再次无症状或认为恢复稳定时,随访结束。记录术后并发症。结果共30例患者(男23例,女7例;31日肘部;包括1例双侧/29例单侧)。平均随访11.1个月(1-64)。术中所有活动区域的平均关节振幅均增加,包括伸/屈从86°增加到132.6°(P = 0.001),旋/旋从163.9°增加到179.7°(P = 0.025)。在最长的随访中,伸展/屈曲关节的平均振幅从86°增加到118.9°(P = 0.002),旋前/旋前关节的平均振幅从136.9°增加到173.9°(P = 0.022)。伸/屈关节的平均缺损从54°减少到21.1°(P = 0.001),旋/前旋关节的平均缺损从16.1°减少到6.1°(P = 0.006)。伸/屈弧线的平均增益为31.5°,旋/旋弧线的平均增益为10°。屈伸损失有限(平均:14.2°,极端:50°)。该研究未发现神经系统并发症。结论经Outerbridge-Kashiwagi手术的纯后路关节镜下关节松解术和前囊切除术是安全有效的。临床结果显示,术中和术后关节屈伸和旋前活动范围均有改善,无术后神经系统并发症。证据水平:IV级,治疗性病例系列。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.70
自引率
0.00%
发文量
218
审稿时长
45 weeks
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