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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2024, Vol. 10 ›› Issue (01) : 57 -64. doi: 10.3877/cma.j.issn.2096-0263.2024.01.010

综述

肘关节骨关节炎手术治疗进展
陈仁杰1, 鲁谊1,†()   
  1. 1. 首都医科大学附属北京积水潭医院运动医学科
  • 收稿日期:2023-09-23 出版日期:2024-02-05
  • 通信作者: 鲁谊
  • 基金资助:
    北京自然科学面上项目基金(7222085)

Progress in surgical treatment of elbow osteoarthritis

Renjie Chen1, Yi Lu1,†()   

  1. 1. Department of Sports medicine, Beijing Jishuitan Hospital, Capital Medical University, Beijing 100035, China
  • Received:2023-09-23 Published:2024-02-05
  • Corresponding author: Yi Lu
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引用本文：

陈仁杰, 鲁谊. 肘关节骨关节炎手术治疗进展[J]. 中华老年骨科与康复电子杂志, 2024, 10(01): 57-64.

Renjie Chen, Yi Lu. Progress in surgical treatment of elbow osteoarthritis[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2024, 10(01): 57-64.

肘关节骨关节炎是以关节疼痛、活动受限为主要症状，好发于体力劳动者的退行性病变，随着经济的发展和社会的进步，越来越多的患者受到肘骨关节炎的困扰。其病因尚不明确，可能与肘关节的过度使用有关。肘骨关节炎的治疗包括非手术治疗与手术治疗。对于疼痛较轻、关节活动受限不严重的患者，治疗以非手术治疗为主，对经规范非手术治疗无效或症状较为严重的患者，则应考虑手术治疗。目前用以治疗该疾病的手术方式种类较多，最常用手术方式有：切开肘关节成型术、关节镜肘关节成型术、全肘关节置换术。除此之外，还有一些手术方式也被应用于肘关节骨性关节炎的治疗，包括：Outerbridge-Kashiwagi (O-K)手术、肘关节间置成型术、肱桡关节置换术、肱骨远端半肘关节置换术等。各类手术方式对于处理不同类型的肘骨关节炎均有自己独特的优势，如切开肘关节成型术在改善患者肘关节活动度方面更具优势，而关节镜肘关节成型术则有着更低的术后并发症发生率，肘关节间置成型术适用于年轻的肘关节骨关节炎患者，肱桡关节置换术对于发生于肱桡关节的肘骨性关节炎独具优势，因此治疗时选择合适的手术方式尤为重要。本文结合既往文献，就各种治疗肘骨关节炎的手术方式展开综述，探讨各类手术的适应症及优缺点，以期为肘骨关节炎手术治疗时方案选择提供参考。

关键词: 肘关节, 骨关节炎, 手术治疗, 关节成型术

Elbow osteoarthritis is a degenerative disease with pain and limited activity. It often occurs in manual workers. With the development of economy and the progress of society, more and more patients are suffering from elbow osteoarthritis. The cause is unknown and may be related to overuse of the elbow.The treatment of elbow osteoarthritis includes non-surgical treatment and surgical treatment. For patients with mild pain and limited joint movement, non-surgical treatment is the firstchoice, and for patients after ineffective standard non-surgical treatment or with more severe symptoms, surgical treatment should be considered. At present, there are many kinds of surgical methods used to treat this disease, the most common surgical methods including: open elbow arthroplasty, arthroscopic elbow arthroplasty, total elbow arthroplasty. In addition, a number of surgical procedures have also been used for the treatment of elbow osteoarthritis, including Outerbridge-Kashiwagi (O-K) surgery, elbow interposition plasty, radiocapitellar arthroplasty, and elbowhemiarthroplasty. Each surgical method has its own unique advantages in treating different types of elbow osteoarthritis. For example, incision elbow arthroplasty is more advantageous in improving elbow joint motion, while arthroscopic elbow arthroplasty has a lower incidence of postoperative complications. Elbow interposition arthroplasty is suitable for young elbow osteoarthritis patients. Radiocapitellar arthroplasty has unique advantages for elbow osteoarthritis that occurs in the humeroradial joint, so it is particularly important to choose the appropriate surgical method during treatment. Based on previous literature, this article reviews various surgical methods for the treatment of osteoarthritis of the elbow, discusses the indications and advan tages and disadvantages of various surgeries, in order to provide references for the selection of surgical treatment of the elbowosteoarthritis.

Key words: Elbow, Osteoarthritis, Surgical treatment, Arthroplasty
图1~4 不同Broberg-Morrey分级的肘关节的侧位片。图1　正常肘关节分级为0级　图2　关节间隙轻度狭窄伴少量骨赘生成为Ⅰ级　图3　关节间隙中度狭窄伴中度骨赘生成为Ⅱ级　图4　关节严重退变，关节面破坏严重为Ⅲ级。
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