Effectiveness analysis of computer-aided technology in the treatment of primary elbow osteoarthritis combined with stiffness under arthroscopy_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

BI Wenzhi ,  GUO Biao , XU Jian , CUI Honglin , MA Wei , YANG Dongqiang , FU Pengfei , LIU Yijun , TIAN Jinxiang

Department of Orthopedics, Fuyang Hospital Affiliated to Bengbu Medical College (Fuyang People’s Hospital), Fuyang Anhui, 236000, P. R. China;

Corresponding author：

GUO Biao, Email: happygb@126.com

Keywords：

Computer-aided technology; three-dimensional printing; elbow arthroscopy; primary osteoarthritis; stiffness

DOI：

10.7507/1002-1892.202109034

Video：

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Objective To explore the effectiveness of computer-aided technology in the treatment of primary elbow osteoarthritis combined with stiffness under arthroscopy. Methods The clinical data of 32 patients with primary elbow osteoarthritis combined with stiffness between June 2018 and December 2020 were retrospectively analyzed. There were 22 males and 10 females with an average age of 53.4 years (range, 31-71 years). X-ray film and three-dimensional CT examinations showed osteophytes of varying degrees in the elbow joint. Loose bodies existed in 16 cases, and there were 7 cases combined with ulnar nerve entrapment syndrome. The median symptom duration was 2.5 years (range, 3 months to 22.5 years). The location of bone impingement from 0° extension to 140° flexion of the elbow joint was simulated by computer-aided technology before operation and a three-dimensional printed model was used to visualize the amount and scope of impinging osteophytes removal from the anterior and posterior elbow joint to accurately guide the operation. Meanwhile, the effect of elbow joint release and impinging osteophytes removal was examined visually under arthroscopy. The visual analogue scale (VAS) score, Mayo elbow performance score (MEPS), and elbow range of motion (extension, flexion, extension and flexion) were compared between before and after operation to evaluate elbow function. Results The mean operation time was 108 minutes (range, 50-160 minutes). All 32 patients were followed up 9-18 months with an average of 12.5 months. There was no other complication such as infection, nervous system injury, joint cavity effusion, and heterotopic ossification, except 2 cases with postoperative joint contracture at 3 weeks after operation due to the failure to persist in regular functional exercises. Loose bodies of elbow and impinging osteophytes were removed completely for all patients, and functional recovery was satisfactory. At last follow-up, VAS score, MEPS score, extension, flexion, flexion and extension range of motion significantly improved when compared with preoperative ones (P<0.05). Conclusion Arthroscopic treatment of primary elbow osteoarthritis combined with stiffness using computer-aided technology can significantly reduce pain, achieve satisfactory functional recovery and reliable effectiveness.

Citation： BI Wenzhi, GUO Biao, XU Jian, CUI Honglin, MA Wei, YANG Dongqiang, FU Pengfei, LIU Yijun, TIAN Jinxiang. Effectiveness analysis of computer-aided technology in the treatment of primary elbow osteoarthritis combined with stiffness under arthroscopy. Chinese Journal of Reparative and Reconstructive Surgery, 2022, 36(3): 268-273. doi: 10.7507/1002-1892.202109034 Copy

1.	Kroonen LT, Piper SL, Ghatan AC. Arthroscopic management of elbow osteoarthritis. J Hand Surg (Am), 2017, 42(8): 640-650.
2.	De Klerk HH, Welsink CL, Spaans AJ, et al. Arthroscopic and open debridement in primary elbow osteoarthritis: a systematic review and meta-analysis. EFORT Open Rev, 2020, 5(12): 874-882.
3.	Stanley D. Prevalence and etiology of symptomatic elbow osteoarthritis. J Shoulder Elbow Surg, 1994, 3(6): 386-389.
4.	Sochacki KR, Jack RA, Hirase T, et al. Arthroscopic debridement for primary degenerative osteoarthritis of the elbow leads to significant improvement in range of motion and clinical outcomes: A systematic review. Arthroscopy, 2017, 33(12): 2255-2262.
5.	Holzer N, Ozturk M. Arthroscopic operation for elbow stiffness. Rev Med Suisse, 2019, 15(675): 2284-2287.
6.	Carlier Y, Lenoir H, Rouleau DM, et al. Arthroscopic debridement for osteoarthritis of the elbow: Results and analysis of predictive factors. Orthop Traumatol Surg Res, 2019, 105(8S): S221-S227.
7.	李旭, 鲁谊, 李奉龙, 等. 关节镜治疗肘关节骨关节炎合并活动受限的中长期疗效分析. 中国运动医学杂志, 2015, 34(10): 933-936.
8.	Shigi A, Oka K, Tanaka H, et al. Utility of a 3-dimensionally printed color-coded bone model to visualize impinging osteophytes for arthroscopic débridement arthroplasty in elbow osteoarthritis. J Shoulder Elbow Surg, 2021, 30(5): 1152-1158.
9.	陈昊. 关节镜技术微创治疗肘关节功能障碍的系统研究. 重庆: 第三军医大学, 2017.
10.	Lim YW, van Riet RP, Mittal R, et al. Pattern of osteophyte distribution in primary osteoarthritis of the elbow. J Shoulder Elbow Surg, 2008, 17(6): 963-966.
11.	Dalal S, Bull M, Stanley D. Radiographic changes at the elbow in primary osteoarthritis: a comparison with normal aging of the elbow joint. J Shoulder Elbow Surg, 2007, 16(3): 358-361.
12.	Kwak JM, Kholinne E, Sun Y, et al. Clinical outcome of osteocapsular arthroplasty for primary osteoarthritis of the elbow: Comparison of arthroscopic and open procedure. Arthroscopy, 2019, 35(4): 1083-1089.
13.	Guerrero EM, Bullock GS, Helmkamp JK, et al. The clinical impact of arthroscopic vs. open osteocapsular débridement for primary osteoarthritis of the elbow:a systematic review. J Shoulder Elbow Surg, 2020, 29(4): 689-698.
14.	Kim DM, Han M, Jeon IH, et al. Range-of-motion improvement and complication rate in open and arthroscopic osteocapsular arthroplasty for primary osteoarthritis of the elbow: a systematic review. Int Orthop, 2020, 44(2): 329-339.
15.	Kodde IF, van Rijn J, van den Bekerom MP, et al. Surgical treatment of post-traumatic elbow stiffness: a systematic review. J Shoulder Elbow Surg, 2013, 22(4): 574-580.
16.	杨勇, 王福川, 郑小飞, 等. 肘关节僵硬的关节镜松解治疗. 实用医学杂志, 2019, 35(8): 1260-1264.
17.	Galle SE, Beck JD, Burchette RJ, et al. Outcomes of elbow arthroscopic osteocapsular arthroplasty. J Hand Surg (Am), 2016, 41(2): 184-191.
18.	Kamineni S, Hirahara H, Pomianowski S, et al. Partial posteromedial olecranon resection: a kinematic study. J Bone Joint Surg (Am), 2003, 85(6): 1005-1011.
19.	Wu X, Wang H, Meng C, et al. Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness. Knee Surg Sports Traumatol Arthrosc, 2015, 23(9): 2715-2720.
20.	Temporin K, Shimada K, Oura K, et al. Arthroscopic release for the severely stiff elbow. Musculoskelet Surg, 2020, 104(1): 81-86.
21.	Pederzini LA, Nicoletta F, Tosi M, et al. Elbow arthroscopy in stiff elbow. Knee Surg Sports Traumatol Arthrosc, 2014, 22(2): 467-473.
22.	鲁谊, 李旭, 李奉龙, 等. 205例肘关节镜术后并发症分析. 中国运动医学杂志, 2015, 34(8): 721-725.
23.	Visonà E, Vio S, Franceschi G, et al. Orthopedic resident’s learning curve for arthroscopic subscapularis tendon repair: short-term clinical and radiographic outcomes. Musculoskelet Surg, 2017, 101(Suppl 2): 145-151.

1. Kroonen LT, Piper SL, Ghatan AC. Arthroscopic management of elbow osteoarthritis. J Hand Surg (Am), 2017, 42(8): 640-650.
2. De Klerk HH, Welsink CL, Spaans AJ, et al. Arthroscopic and open debridement in primary elbow osteoarthritis: a systematic review and meta-analysis. EFORT Open Rev, 2020, 5(12): 874-882.
3. Stanley D. Prevalence and etiology of symptomatic elbow osteoarthritis. J Shoulder Elbow Surg, 1994, 3(6): 386-389.
4. Sochacki KR, Jack RA, Hirase T, et al. Arthroscopic debridement for primary degenerative osteoarthritis of the elbow leads to significant improvement in range of motion and clinical outcomes: A systematic review. Arthroscopy, 2017, 33(12): 2255-2262.
5. Holzer N, Ozturk M. Arthroscopic operation for elbow stiffness. Rev Med Suisse, 2019, 15(675): 2284-2287.
6. Carlier Y, Lenoir H, Rouleau DM, et al. Arthroscopic debridement for osteoarthritis of the elbow: Results and analysis of predictive factors. Orthop Traumatol Surg Res, 2019, 105(8S): S221-S227.
7. 李旭, 鲁谊, 李奉龙, 等. 关节镜治疗肘关节骨关节炎合并活动受限的中长期疗效分析. 中国运动医学杂志, 2015, 34(10): 933-936.
8. Shigi A, Oka K, Tanaka H, et al. Utility of a 3-dimensionally printed color-coded bone model to visualize impinging osteophytes for arthroscopic débridement arthroplasty in elbow osteoarthritis. J Shoulder Elbow Surg, 2021, 30(5): 1152-1158.
9. 陈昊. 关节镜技术微创治疗肘关节功能障碍的系统研究. 重庆: 第三军医大学, 2017.
10. Lim YW, van Riet RP, Mittal R, et al. Pattern of osteophyte distribution in primary osteoarthritis of the elbow. J Shoulder Elbow Surg, 2008, 17(6): 963-966.
11. Dalal S, Bull M, Stanley D. Radiographic changes at the elbow in primary osteoarthritis: a comparison with normal aging of the elbow joint. J Shoulder Elbow Surg, 2007, 16(3): 358-361.
12. Kwak JM, Kholinne E, Sun Y, et al. Clinical outcome of osteocapsular arthroplasty for primary osteoarthritis of the elbow: Comparison of arthroscopic and open procedure. Arthroscopy, 2019, 35(4): 1083-1089.
13. Guerrero EM, Bullock GS, Helmkamp JK, et al. The clinical impact of arthroscopic vs. open osteocapsular débridement for primary osteoarthritis of the elbow:a systematic review. J Shoulder Elbow Surg, 2020, 29(4): 689-698.
14. Kim DM, Han M, Jeon IH, et al. Range-of-motion improvement and complication rate in open and arthroscopic osteocapsular arthroplasty for primary osteoarthritis of the elbow: a systematic review. Int Orthop, 2020, 44(2): 329-339.
15. Kodde IF, van Rijn J, van den Bekerom MP, et al. Surgical treatment of post-traumatic elbow stiffness: a systematic review. J Shoulder Elbow Surg, 2013, 22(4): 574-580.
16. 杨勇, 王福川, 郑小飞, 等. 肘关节僵硬的关节镜松解治疗. 实用医学杂志, 2019, 35(8): 1260-1264.
17. Galle SE, Beck JD, Burchette RJ, et al. Outcomes of elbow arthroscopic osteocapsular arthroplasty. J Hand Surg (Am), 2016, 41(2): 184-191.
18. Kamineni S, Hirahara H, Pomianowski S, et al. Partial posteromedial olecranon resection: a kinematic study. J Bone Joint Surg (Am), 2003, 85(6): 1005-1011.
19. Wu X, Wang H, Meng C, et al. Outcomes of arthroscopic arthrolysis for the post-traumatic elbow stiffness. Knee Surg Sports Traumatol Arthrosc, 2015, 23(9): 2715-2720.
20. Temporin K, Shimada K, Oura K, et al. Arthroscopic release for the severely stiff elbow. Musculoskelet Surg, 2020, 104(1): 81-86.
21. Pederzini LA, Nicoletta F, Tosi M, et al. Elbow arthroscopy in stiff elbow. Knee Surg Sports Traumatol Arthrosc, 2014, 22(2): 467-473.
22. 鲁谊, 李旭, 李奉龙, 等. 205例肘关节镜术后并发症分析. 中国运动医学杂志, 2015, 34(8): 721-725.
23. Visonà E, Vio S, Franceschi G, et al. Orthopedic resident’s learning curve for arthroscopic subscapularis tendon repair: short-term clinical and radiographic outcomes. Musculoskelet Surg, 2017, 101(Suppl 2): 145-151.

Chinese Journal of Reparative and Reconstructive Surgery

Effectiveness analysis of computer-aided technology in the treatment of primary elbow osteoarthritis combined with stiffness under arthroscopy

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