Comprehensive assessment of clinical outcome and quality of life after total elbow arthroplasty.
OBJECTIVE
To assess quantitatively the outcome and to explore the physiometric and psychometric properties of clinical, generic, and condition-specific instruments after total elbow arthroplasty.


METHODS
Seventy-nine patients were assessed in a 6-19-year cross-sectional catamnesis by means of 6 widely used questionnaires, clinical examinations, and radiographic examinations.


RESULTS
With regard to pain, general physical health, and all the mental health dimensions of the Short Form 36 (SF-36), the patients showed scores comparable to normative values. Elbow joint stability and satisfaction were both good. Significant functional limitation was evidenced by the low mean scores of the SF-36 physical functioning measure (48.7, normative 69.9) and the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH) function measure (51.1, normative 89.3). The SF-36 physical component summary and the DASH correlated highly (r = 0.76) and, in factor analysis, loaded on the factor "physical unspecific." The patient and clinical modified American Shoulder and Elbow Surgeons questionnaire (mASES) correlated with the Patient Related Elbow Evaluation form (r = 0.92 with the patient mASES) and loaded on "physical specific." The SF-36 mental component summary loaded on "mental quality of life."


CONCLUSIONS
The patients' self-rated health, quality of life, and clinical outcome were good and were not affected by impairment in some specific functional abilities. A questionnaire set comprising the SF-36 and the patient and clinical mASES is proposed for the comprehensive and specific assessment of outcome after elbow arthroplasty.
Angst
Felix
F
Schulthess Klinik, Zurich, Switzerland. fangst@datacomm.ch
John
Michael
M
Pap
Géza
G
Mannion
Anne F
AF
Herren
Daniel B
DB
Flury
Matthias
M
Aeschlimann
André
A
Schwyzer
Hans-Kaspar
HK
Simmen
Beat R
BR
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D001178:Arthroplasty; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D004550:Elbow / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000379:methods / Q000592:standards; D011788:Quality of Life; D015203:Reproducibility of Results; D016896:Treatment Outcome