دورية أكاديمية
Anconeus-sparing minimally invasive approach for lateral ulnar collateral ligament reconstruction using a triceps tendon autograft is an effective and safe treatment for chronic posterolateral instability of the elbow.
| العنوان: | Anconeus-sparing minimally invasive approach for lateral ulnar collateral ligament reconstruction using a triceps tendon autograft is an effective and safe treatment for chronic posterolateral instability of the elbow. |
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| المؤلفون: | Soler A; Department of Trauma Surgery, University Medical Centre, Regensburg, Germany., Voss A; Department of Trauma Surgery, University Medical Centre, Regensburg, Germany; Sporthopaedicum Regensburg, Regensburg, Germany., Schramm S; Department of Trauma Surgery, University Medical Centre, Regensburg, Germany., Greiner S; Department of Trauma Surgery, University Medical Centre, Regensburg, Germany; Sporthopaedicum Regensburg, Regensburg, Germany. Electronic address: greiner@sporthopaedicum.de. |
| المصدر: | Journal of shoulder and elbow surgery [J Shoulder Elbow Surg] 2024 May; Vol. 33 (5), pp. 1116-1124. Date of Electronic Publication: 2024 Jan 03. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 9206499 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-6500 (Electronic) Linking ISSN: 10582746 NLM ISO Abbreviation: J Shoulder Elbow Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: St. Louis, MO : Mosby Original Publication: St. Louis, MO : Mosby Yearbook, Inc., c1992- |
| مواضيع طبية MeSH: | Ulnar Collateral Ligament Reconstruction*/adverse effects , Joint Instability*/etiology , Elbow Joint*/diagnostic imaging , Elbow Joint*/surgery , Collateral Ligament, Ulnar*/surgery , Collateral Ligaments*/surgery, Humans ; Adult ; Middle Aged ; Elbow/surgery ; Autografts ; Tendons/transplantation ; Range of Motion, Articular ; Pain |
| مستخلص: | Background: Surgical treatment helps to restore stability of the elbow in patients with posterolateral rotatory instability (PLRI). The anconeus muscle is one of the most important active stabilizers against PLRI. A minimally invasive anconeus-sparing approach for lateral ulnar collateral ligament (LUCL) reconstruction using a triceps tendon autograft has been previously described. The purpose of this study was to evaluate the outcome of this intervention and identify risk factors that influenced the clinical and patient-reported outcomes. Methods: Sixty-one patients with chronic PLRI and no previous elbow surgery who underwent surgical reconstruction of the LUCL using a triceps tendon autograft in a minimally invasive anconeus-sparing approach during 2012 and 2018 were evaluated. Outcome measures included a clinical examination and the Oxford Elbow Score (OES) and the Mayo Elbow Performance Score (MEPS) questionnaires. Subjective patient outcomes were evaluated with the visual analog scale (VAS) for pain and the Subjective Elbow Value (SEV). Integrity of the common extensor tendons and centering of the radial head were assessed preoperatively on standardized magnetic resonance images (MRIs). Results: Fifty-two patients were available at final follow-up. The mean age of patients was 51 ± 12 years with a mean follow-up of 53 ± 14 months (range 20-76). Clinical examination after surgery (n = 41) showed no clinical signs of instability in 98% of the patients (P < .001) and a nonsignificant improvement in range of motion. OES, MEPS, and VAS scores averaged 40 ± 10 of 48 points, 92 ± 12 of 100 points, and 1 ± 2 points, respectively, all corresponding with good or excellent outcomes. The SEV was 88%, indicating very high satisfaction with the surgery. Only 1 patient had revision surgery due to pain, and there were no reported postoperative complications in this cohort. A radial head subluxation in the MRI correlated significantly with worse postoperative outcomes. Conclusions: The anconeus-sparing minimally invasive technique for posterolateral stabilization of the elbow using a triceps tendon autograft is an effective and safe treatment for chronic posterolateral instability of the elbow with substantial improvements in elbow function and pain relief with a very low rate of persistent clinical instability. (Copyright © 2024 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: PLRI; Posterolateral elbow instability; anconeus muscle; lateral ulnar collateral ligament; minimal invasive surgery |
| تواريخ الأحداث: | Date Created: 20240105 Date Completed: 20240415 Latest Revision: 20240415 |
| رمز التحديث: | 20240415 |
| DOI: | 10.1016/j.jse.2023.11.017 |
| PMID: | 38182022 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1532-6500 |
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| DOI: | 10.1016/j.jse.2023.11.017 |