使用关节镜技术治疗肘关节类风湿性关节炎Larsen 3-4期患者的短期临床疗效。

对12例诊断明确的肘关节类风湿性关节炎患者进行关节镜治疗，术前经影像学检查均为Larsen 3-4期，术中依次于后侧间室、前侧间室及肱桡间室行肘关节探查及滑膜切除术清理肘关节腔。平均随访14.8个月，术前术后使用肘关节视觉模拟评分（visual analogue scale，VAS）、肘关节屈伸活动度及Mayo肘关节功能评分进行疗效评定。

术后肘关节VAS疼痛评分从术前（6.36±0.92）分下降至（2.00±0.77）分，屈伸活动度从术前（63.28±8.58）°上升至（107.28±4.60）°。Mayo肘关节功能评分从术前（49.94±6.56）分提高至（77.27±4.67）分，优2例、良7例、中3例。短期内无患者出现滑膜炎复发。所有接受手术患者主观感受非常满意。

关节镜治疗Larsen 3-4期肘关节类风湿性关节炎在短期内的疗效令人满意，经过术中仔细滑膜清理，该技术可有效减轻疼痛、恢复肘关节的活动度、改善肘关节功能从而提高患者生活质量，短期疗效值得肯定。

Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease that affects approximately 1% of the global population. The lesions mainly exist in synovial tissue, leading to synovitis and further bone destruction, such as erosion or cartilage damage. Once affected, the elbow joint, as the central axis joint of the upper limb, will seriously affect the function of the upper limb, thereby affecting daily life. In the early stages of rheumatoid arthritis, when anti-rheumatoid drugs cannot control pain and inflammation, incision synovectomy was previously used in patients with elbow rheumatoid arthritis to alleviate pain and inflammation. However, it still presents higher postoperative complications, such as wound non-healing, infection, and joint stiffness. The therapeutic effect is significant after arthroscopic synovectomy of the rheumatoid elbow joint, especially in pain relief. Arthroscopic synovectomy has less trauma than open synovectomy. Despite the potential risk of nerve damage, it has the advantages of minimal postoperative pain, low risk of stiffness, and early activity recovery. This group used synovectomy under elbow arthroscopy to treat 12 cases of Larsen 3-4 stage rheumatoid elbow arthritis. After a short-term follow-up, the therapeutic effect was good.

To investigate the short-term clinical efficacy of arthroscopic techniques to treat patients with Larsen stage 3-4 of elbow rheumatoid arthritis.

Arthroscopic treatment was performed on 12 patients with well-defined rheumatoid arthritis of the elbow joint. The preoperative imaging examination showed Larsen staging of 3-4 stages. During the surgery, elbow joint exploration and synovectomy were performed sequentially in the posterior, anterior, and brachioradial compartments to clean the elbow joint cavity. The average follow-up was 14.8 months, and the efficacy was evaluated using the elbow joint VAS pain score, elbow joint flexion and extension range of motion, and Mayo elbow joint function score before and after surgery.

The postoperative VAS pain score of the elbow joint decreased from (6.36 ± 0.92) points to (2.00 ± 0.77) points, and the flexion and extension range of motion increased from (63.28 ± 8.58) ° to (107.28 ± 4.60) °. The Mayo elbow joint function score increased from (49.94 ± 6.56) points before surgery to (77.27 ± 4.67) points, with 2 cases being excellent, 7 cases being good, and 3 cases being moderate. No patient experienced synovitis recurrence in the short term. All patients who underwent surgery have a very satisfactory subjective experience.

The short-term efficacy of arthroscopic treatment for Larsen stage 3-4 rheumatoid arthritis of the elbow is satisfactory. After careful synovial clearance during surgery, this technique can effectively reduce pain, restore elbow joint mobility, improve elbow joint function, and improve patient quality of life. The short-term efficacy is worthy of recognition.