■外侧上髁炎(LE)是肘部外侧疼痛的最常见原因之一。当非手术治疗失败时,3种手术方法中的1种-开放,经皮,或关节镜-使用。然而,确定哪种方法具有更好的临床结局仍存在争议.
■定性和定量地审查不同手术方式对LE的结果。
■系统评价;证据水平,4.
■本综述是根据PRISMA(系统评价和荟萃分析的首选报告项目)指南进行和报告的。发表在PubMed上的研究,Medline(通过EBSCO),和ScienceDirect数据库以开放的方式对待LE,经皮,包括至少12个月随访的关节镜入路.使用Cochrane偏差风险2工具和非随机研究方法学指数评分评估研究质量。主要结果是每种手术治疗方法的成功率-开放,经皮,和关节镜。
■从603项研究的初步搜索结果来看,最终纳入了43项研究(n=1941肘部)。与经皮(91%[95%CI,87.3%-94.6%])和开放(82.7%[95%CI,75.6%-89.8%])的LE手术相比,关节镜入路的成功率最高(91.9%[95%CI,89.2%-94.7%]),平均视觉模拟量表疼痛评分的变化分别为5.54、4.90和3.63。根据手臂的残疾,肩和手的评分,关节镜组的功能结果有所改善(从54.11提高到15.47),经皮组(从44.90到10.47),和开放组(从53.55到16.13)。在MayoElbow性能评分中也发现了整体改善,关节镜组(从55.12到90.97),经皮组从56.31到87.65,和开放组(从64到93.37)。
■关节镜手术在3种LE手术方法中成功率最高,功能结局改善最好。
UNASSIGNED: Lateral epicondylitis (LE) is one of the most common causes of lateral elbow pain. When nonoperative treatment fails, 1 of the 3 surgical approaches-open, percutaneous, or arthroscopic-is used. However, determining which approach has the superior clinical outcome remains controversial.
UNASSIGNED: To
review the outcomes of different operative modalities for LE qualitatively and quantitatively.
UNASSIGNED: Systematic
review; Level of evidence, 4.
UNASSIGNED: This
review was performed and reported according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies published in PubMed, Medline (via EBSCO), and ScienceDirect databases that treated LE with open, percutaneous, or arthroscopic approaches with at least 12 months of follow-up were included. Study quality was assessed using the Cochrane Risk of Bias 2 tool and the Methodological Index for Non-Randomized Studies score. The primary outcome was the success rate of each operative treatment approach-open, percutaneous, and arthroscopic.
UNASSIGNED: From an initial search result of 603 studies, 43 studies (n = 1941 elbows) were ultimately included. The arthroscopic approach had the highest success rate (91.9% [95% CI, 89.2%-94.7%]) compared with the percutaneous (91% [95% CI, 87.3%-94.6%]) and open (82.7% [95% CI, 75.6%-89.8%]) approaches for LE surgery with changes in the mean visual analog scale pain score of 5.54, 4.90, and 3.63, respectively. According to the Disabilities of the Arm, Shoulder and Hand score, the functional outcome improved in the arthroscopic group (from 54.11 to 15.47), the percutaneous group (from 44.90 to 10.47), and the open group (from 53.55 to 16.13). The overall improvement was also found in the Mayo Elbow Performance Score, the arthroscopic group (from 55.12 to 90.97), the percutaneous group (from 56.31 to 87.65), and the open group (from 64 to 93.37).
UNASSIGNED: Arthroscopic surgery had the highest rate of success and the best improvement in functional outcomes among the 3 approaches of LE surgery.