关节镜手术治疗顽固性网球肘中缝合锚钉置入位置与临床功能相关性研究  

Effects of the Suture Anchor Position on Post-operative Function after Arthroscopic Treatment of the Recalcitrant Tennis Elbow

作　　者：孙铂林 李尚哲 李旭[1] 杨珖 张海龙[1] 鲁谊[1] Sun Bolin;Li Shangzhe;Li Xu;Yang Guang;Zhang Hailong;Lu Yi(Department of Sports Medicine,Beijing Jishuitan Hospital,Beijing 100035,China)

机构地区：[1]北京积水潭医院运动医学科,北京100035

出　　处：《中国运动医学杂志》2022年第9期680-686,共7页Chinese Journal of Sports Medicine

基　　金：首都卫生发展科研专项基金(2020-2-2073);国家自然科学基金(82172512)。

摘　　要：目的:探讨关节镜手术治疗顽固性网球肘过程中缝合锚钉置入位置与患者术后功能的相关性。方法:回顾性分析2014年6月至2021年12月42例关节镜治疗的顽固性网球肘患者的临床资料,其中男性28例、女性14例,年龄46.5±7.9岁(34~60岁),出现症状至手术时间为15.7±10.6个月(6~36个月)。以关节镜下确认桡侧腕短伸肌损伤为金标准,通过术后即刻三维CT扫描对缝合锚钉的置入位置进行评估并分为锚钉位置良好组(n=24)与锚钉位置不佳组(n=18),评估两组患者术前、术后3周、术后6个月随访的上肢功能评定表(DASH)、梅奥肘关节功能评分(MEPS)、疼痛视觉模拟评分(VAS)的差异。结果:患者VAS评分在术前、术后3周、术后6个月分别为6.8±1.9,4.4±2.3,1.3±1.4。MEPS评分在术前、术后3周、术后6个月分别为67.4±15.6,70.2±17.2,90±9.9。DASH评分在术前、术后3周、术后6个月分别为47.5±22.4,52.4±18.2,10.2±10.1。与术前相比,术后3周VAS评分明显下降(P=0.002),MEPS评分、DASH评分没有明显改善(P=0.273,P=0.366)。与术后3周相比,术后6个月VAS评分、MEPS评分、DASH评分均有明显改善(P<0.001)。两组进行比较,术前和术后3周VAS评分、MEPS评分、DASH评分均无显著性差异(P>0.05)。术后6个月,锚钉位置良好组VAS评分、MEPS评分优于锚钉位置不佳组(P=0.027,P=0.007),DASH评分两组无明显差异(P=0.092)。结论:顽固性网球肘的关节镜下桡侧腕短伸肌清创缝合术效果良好;缝合锚钉位置会对患者术后功能恢复产生一定影响。Objective To evaluate the effect of the suture anchor position on the post-operative function after the arthroscopic treatment of the recalcitrant tennis elbow.Methods The clinical data of 42patients with recalcitrant tennis elbow and treated between June 2014 and December 2021 were explored retrospectively.The patients included 28 males and 14 females,with an average age of 46.5±7.9 years old(34~60).The average time of onset-to-operation was 15.7±10.6 months(6~36 months).Immediately after the operation,the three-dimensional CT scan was conducted to evaluate the suture anchor position.Based on the golden standard for the damage of the extensor carpi radialis brevis(ECRB)under arthroscopy,all patients were randomly divided into a good position group(n=24)and a poor position group(n=18).Before,as well as 3 weeks and 6 months after the operation,both groups were assessed using the visual analogue scale(VAS),Mayo Elbow performance score(MEPS),as well as disabilities of the arm,shoulder and hand(DASH).Results Before,as well as 3 weeks and 6 months after the operation,the average VAS,MEPS and DASH scores were 6.8±1.9,4.4±2.3 and 1.3±1.4,67.4±15.6,70.2±17.2 and 90±9.9,as well as 47.5±22.4,52.4±18.2and 10.2±10.1 respectively.Compared with before the operation,3 weeks after the operation,the average VAS score decreased significantly(P=0.002),but no significant improvement was observed in the average MEPS and DASH scores(P=0.273,P=0.366).However,compared with 3 weeks postoperatively,the average VAS,MEPS and DASH scores improved significantly 6 months after the operation(P<0.001).Before and 3 weeks after the operation,there were no significant differences between the two groups in the average VAS,MEPS and DASH scores(P>0.05).Meanwhile,6 months after the operation,the average VAS and MEPS scores of the good position group were significantly better than the poor position group(P=0.027 and P=0.007),and there was no significant difference between the two groups in the average DASH score(P=0.092).Conclusion Arthroscop

关 键 词：网球肘 缝合 锚钉 功能 关节镜 

分 类 号：R687.4[医药卫生—骨科学]