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Tratamento artroscópico da epicondilite lateral crônica

Authors: Terra, Bernardo Barcellos; Rodrigues, Leandro Marano; Filho, Anis Nahssen; Almeida, Gustavo Dalla Bernardina de; Cavatte, José Maria; De Nadai, Anderson;

Tratamento artroscópico da epicondilite lateral crônica

Abstract

ResumoObjetivoRelatar os resultados clínicos e funcionais da liberação artroscópica do extensor radial curto do carpo (ECRB) nos pacientes com epicondilite lateral crônica refratária ao tratamento conservador.MétodosNo 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 anatômicos em cadáver. Os critérios de inclusão foram pacientes com epicondilite lateral nos quais o tratamento conservador (analgésicos, antiinflamatórios, infiltração 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.ResultadosForam 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 diferença significante entre pré e pós‐cirúrgico nos três escores funcionais usados (p0,05).ConclusãoO tratamento artroscópico da epicondilite lateral mostra‐se como uma opção terapêutica segura e eficaz quando indicado e feito de forma adequada nos casos refratários de epicondilite lateral crônica e permite ainda uma excelente visualização do espaço articular para diagnóstico e tratamento de patologias associadas com um procedimento minimamente invasivo.AbstractObjectiveTo 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.MethodsOver 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.ResultsA 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 (p0.05).ConclusionArthroscopic 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.

Keywords

Arthroscopy, Cotovelo de tenista/terapia, Tennis elbow/complications, Tennis elbow/therapy, Cotovelo de tenista/cirurgia, Cotovelo de tenista/complicações, Surgery, Artroscopia, Tennis elbow/surgery

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
5
Average
Average
Average
gold