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Tratamento artroscópico da epicondilite lateral cr?nica

机译:关节镜治疗慢性外侧上con炎

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ResumoObjetivo Relatar os resultados clínicos e funcionais da libera??o artroscópica do extensor radial curto do carpo (ECRB) nos pacientes com epicondilite lateral cr?nica refratária ao tratamento conservador. Métodos No período compreendido entre janeiro de 2012 e novembro de 2013, 15 pacientes foram submetidos ao tratamento artroscópico. A técnica cirúrgica usada é a descrita por Romeo e Cohen, baseada em estudos anat?micos em cadáver. Os critérios de inclus?o foram pacientes com epicondilite lateral nos quais o tratamento conservador (analgésicos, antiinflamatórios, infiltra??o de corticoides, fisioterapia) falhou por mais de seis meses. Os pacientes foram avaliados com base no escore funcional de cotovelo da Clinica Mayo, Sistema de Estágio de Nirschl e escala visual analógica de dor. Resultados Foram incluídos 15 pacientes, nove homens e seis mulheres. A média do escore funcional de cotovelo de Mayo pós‐operatório foi de 95 (de 90 a 100). A {EVS} da dor teve uma melhoria média de 9,2 no pré‐operatório para 0,64 no pós‐operatório. Pela escala de Nirschl os pacientes apresentaram uma melhoria média de 6,5 no pré‐operatório para aproximadamente um. Foi observada diferen?a significante entre pré e pós‐cirúrgico nos três escores funcionais usados (p 0,05). Conclus?o O tratamento artroscópico da epicondilite lateral mostra‐se como uma op??o terapêutica segura e eficaz quando indicado e feito de forma adequada nos casos refratários de epicondilite lateral cr?nica e permite ainda uma excelente visualiza??o do espa?o articular para diagnóstico e tratamento de patologias associadas com um procedimento minimamente invasivo. Abstract Objective To report the clinical and functional results from arthroscopic release of the short radial extensor of the carpus (SREC) in patients with chronic lateral epicondylitis that was refractory to conservative treatment. Methods Over the period from January 2012 to November 2013, 15 patients underwent arthroscopic treatment. The surgical technique used was the one described by Romeo and Cohen, based on anatomical studies on cadavers. The inclusion criteria were that the patients needed to present lateral epicondylitis and that conservative treatment (analgesics, anti‐inflammatory agents, corticoid infiltration or physiotherapy) had failed over a period of more than six months. The patients were evaluated based on the elbow functional score of the Mayo Clinic, Nirschl's staging system and a visual analogue scale (VAS) for pain. Results A total of 15 patients (nine men and six women) were included. The mean Mayo elbow functional score after the operation was 95 (ranging from 90 to 100). The pain {VAS} improved from a mean of 9.2 before the operation to 0.64 after the operation. On Nirschl's scale, the patients presented an improvement from a mean of 6.5 before the operation to approximately one. There were significant differences from before to after the surgery for the three functional scores used (p 0.05). Conclusion Arthroscopic treatment for lateral epicondylitis was shown to be a safe and effective therapeutic option when appropriately indicated and performed, in refractory cases of chronic lateral epicondylitis. It also allowed excellent viewing of the joint space for diagnosing and treating associated pathological conditions, with a minimally invasive procedure.
机译:摘要目的报告关节镜下the骨腕短伸肌(ECRB)释放在保守治疗难以治疗的慢性外侧上con炎患者中的临床和功能结果。方法2012年1月至2013年11月,对15例患者行关节镜检查。根据尸体的解剖学研究,Romeo和Cohen描述了所使用的外科技术。纳入标准为外侧上con炎患者,其保守治疗(镇痛药,抗炎药,皮质类固醇浸润,物理疗法)失败超过六个月。根据Clinica Mayo的功能性肘关节评分,Nirschl分期系统和视觉模拟疼痛量表对患者进行评估。结果共纳入15例患者,其中男9例,女6例。术后Mayo功能肘平均得分为95(从90到100)。疼痛{EVS}平均从术前的9.2%提高到术后的0.64。使用Nirschl量表,患者术前平均改善6.5左右至大约1。在使用的三个功能评分中,术前和术后之间存在显着差异(p 0.05)。结论关节镜治疗外侧上lateral骨炎被证明是一种安全有效的治疗选择,在难治性慢性外侧上con骨炎病例中得到适当的指示和正确的治疗,并且可以很好地观察到空间。 o明确诊断和治疗与微创手术相关的病理。摘要目的报告关节镜下松解radial骨短radial伸肌(SREC)的临床疗效,以保守治疗难以治愈的慢性外侧上con炎患者。方法2012年1月至2013年11月,对15例患者行关节镜检查。根据对尸体的解剖学研究,Romeo和Cohen描述了一种手术技术。纳入标准是患者需要表现出外侧上con炎,并且保守治疗(镇痛药,抗炎药,皮质类固醇浸润或理疗)在六个多月内均告失败。根据梅奥诊所的肘关节功能评分,Nirschl的分期系统和疼痛的视觉模拟评分表(VAS)对患者进行评估。结果共纳入15例患者(男9例,女6例)。术后平均Mayo肘关节功能评分为95(从90到100)。疼痛{VAS}从手术前的平均9.2改善到手术后的0.64。以Nirschl的量表,患者从术前平均6.5改善到大约1。所使用的三个功能评分在手术前后均存在显着差异(p 0.05)。结论在顽固性慢性外侧上con炎患者中,经适当的指示和手术后,关节镜治疗外侧上lateral炎是一种安全有效的治疗选择。它也可以通过微创手术出色地观察关节间隙,以诊断和治疗相关的病理状况。

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