Effectiveness Analysis Of Computer-aided Technology In The Treatment Of Primary Elbow Osteoarthritis Combined With Stiffness Under Arthroscopy

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 37 patients with primary elbow osteoarthritis combined with stiffness between June 2018 and July 2021 were retrospectively analyzed.There were27 males and 10 females with an average age of 53.70±7.44 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 18 cases,and there were 9 cases combined with ulnar nerve entrapment syndrome.The elbow joint was simulated by computer-aided technology before operation,importing 3D CT image data of the elbow joint into Mimics 19.0 software,then simulating the location of bone impingement from0° extension to 140° flexion of the elbow joint,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(ROM)(extension,flexion,extension and flexion)at preoperative,6 months postoperative and the last follow-up were recorded and compared to evaluate the clinical effect of this operation.Results:The mean operation time was 110 minutes(range,50-165 minutes).All 37 patients were followed up 9-18 months with an average of 13.7 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,and who acquired satisfactory recovery of flexion and extension function after 4 weeks of exercise under the guidance of a rehabilitation instructor.Loose bodies of elbow and impinging osteophytes were removed completely for all patients,and functional recovery was satisfactory.For VAS score,it was 5.71±0.95 at preoperative,1.06±0.31at6 months postoperative,and 0.98±0.29 at the last follow-up,the differences were statistically significant(F=509.969,P<0.001).For MEPS score,it was 54.05±11.29 at preoperative,92.70±7.60 at 6 months postoperative,and 94.73±7.30 at the last follow-up,the differences were statistically significant(F=202.479,P<0.001).For elbow extension,flexion,flexion and extension ROM,they were-30.00°±12.01°,94.51°±11.37° and 64.51°±16.57° at preoperative,-5.32°±3.38°,130.49°±7.46° and125.16°±8.18° at 6 months postoperative,and-7.51°±4.05°,126.59°±7.93°and119.08°±9.09°at the last follow-up respectively,the differences were statistically significant(F=129.240,F=258.298,F=371.789,P<0.001).The VAS score,MEPS score,extension,flexion,flexion and extension ROM after operation were significantly improved than those before operation,the differences all were statistically significant(P<0.05).Compared to 6 months postoperative,the VAS score and MEPS score at the last follow-up were not difference(P>0.05).Compared to 6 months postoperative,the extension,flexion,flexion and extension ROM at the last follow-up were lower,the differences were statistically(P<0.05),the elbow ROM still remained satisfactory.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.