RESUMEN
Objective To assess the effectiveness of arthroscopic debridement techniques for osteoarthrosis of the elbow in nonathlete patients. Methods Twenty-six nonathlete patients with elbow osteoarthrosis were treated with arthroscopic debridement from January 1999 to January 2006.Of the 26 patients,23 were followed for 4～86 months (mean,23 months).All of the 23 patients had complained of pain and loss of elbow motion and 4 patients had symptoms of ulnar neuritis. The Mayo Elbow Performance Score was used as evaluation criteria of the efficacy. Results Twenty-three patients were followed for 4～86 months (mean, 23 months). Twenty elbows (87%) were not painful or were only mildly painful, and three (13%) were moderately painful. The mean arc of flexion-extension was improved from 99.6? (range, 65?～135?) preoperatively to 122.1? (range, 80?～150?) at the time of follow-up. According to the Mayo Elbow Performance Score, the result was excellent in 16 elbows, good in 4, and fair in 3, with a rate of excellent or good results of 87%. Symptoms of ulnar neuritis disappeared in the 3 patients and continued without aggravation in the remaining 1 patient. Fourteen patients were greatly satisfied with the results, 6 satisfied, and 3 unsatisfied, the satisfactory rate being 87%. One patient reported a delayed ulnar nerve symptoms after operation. Conclusions Arthroscopic debridement techniques for elbow osteoarthrosis in nonathlete patients can yield satisfactory pain relief, significant increase in the range of motion, and quick recovery.
RESUMEN
Freibergs disease is avascular necrosis of the second or third metatarsal bone. Since 1914, numerous causes and treatments have been proposed but no definite single cause and treatment method were developed. The simple method, joint debridement could not recover the pathophysiologic condition of Freibergs disease and the destructive method, metatarsal head resection and prosthetic replacement arthroplasty had many postoperative problems. Recently, dorsiflexion osteotomy, which was described by Gauthier and Elbaz for the first time, and joint debridement and reshaping of the metatarsal head, which was described by Mann, were very effective method to manage Freibergs disease. This paper was aimed to evaluate the result of joint debridement and reshaping of the metatarsal head which were relatively simple, less destructive and safe method in treatment of the advanced Freibergs disease. We treated 7 cases of Freibergs disease from August 1993 to March 1997. The results were as follows: 1. All the patients of the last follow-up improved pain. 2. The passive range of motion was increased from 39.1 preoperatively to 57.6 postoperatively. 3. Follow-up X-rays showed no loose body and further metatarsal head destruction. The above results suggested that the joint debridement and reshaping of metatarsal head provided good result in the treatment of advanced Freibergs disease.