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Archives of Orthopaedic and Trauma Surgery

Published in:

01-05-2004 | Original Article

Outcome assessment after arthrolysis of the elbow

Authors: T. Gosling, M. Blauth, T. Lange, M. Richter, L. Bastian, C. Krettek

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 4/2004

Abstract

Background

In the literature, the outcome after arthrolysis of the elbow is mainly assessed by range of motion (ROM). Our intention was to verify whether this parameter does sufficently estimate the outcome after surgical arthrolysis.

Methods

We performed a retrospective study using the validated Disability of the Arm, Shoulder, and Hand Questionnaire (DASH) as our reference outcome parameter. This score was compared with other outcome parameters such as ROM, Mayo Performance Index (MPI) and SF-36. A total of 59 patients who underwent arthrolysis of the elbow was evaluated 53 months after surgery on average.

Results

The mean ROM was 101° for flexion/extension with a relative gain of 60% and 134° for pronation/supination with a relative gain of 58%. MPI was 84 points on average. The mean DASH was 17.6 and the mean SF-36 67.9. The correlation of these outcome parameters was calculated using Pearson's correlation (two-tailed, significance set at p<0.05). We found a high correlation between DASH and the physical function part of the SF-36 (Cov=-0.87, p<0.05). The correlation of DASH and MPI was moderate (Cov=0.71, p<0.05) and of DASH and ROM poor (Cov=–0.25, p<0.05).

Conclusion

ROM as a single parameter does not sufficently assess the outcome of arthrolysis of the elbow.

Amillo S (1992) Arthrolysis in the relief of post-traumatic stiffness of the elbow. Int Orthop 16:188–190PubMed

Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. J Hand Ther 14:128–146PubMed

Blauth M, Haas NP, Südkamp NP, Happe T (1990) Die Ellenbogenarthrolyse bei posttraumatischer Gelenksteife. Orthopäde 19:332–342

Blauth W, Jäger T (1992) Arthrolysis of the elbow. Orthop Traumatol 1:105–121

Bullinger M (1995) German translation and psychometric testing of the SF-36 Health Survey: preliminary results from the IQOLA Project. International Quality of Life Assessment. Soc Sci Med 41:1359–1366PubMed

Bullinger M (2000) Erfassung der gesundheitsbezogenen Lebensqualität mit dem SF-36-Health-Survey. Bundesgesundheitsbl Gesundheitsforsch Gesundheitsschutz 43:190–197CrossRef

Cohen MS, Hastings H (1998) Post-traumatic contracture of the elbow. J Bone Joint Surg Br 80:805–812CrossRefPubMed

Cooney WP (1993) Contractures of the elbow. In: Morrey BF (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 464–475

Duke JB, Tessler RH, Dell PC (1991) Manipulation of the stiff elbow with patient under anaesthesia. J Hand Surg Am 16:19–24PubMed

10.

Ekelund A, Brosjo O, Nilsson OS (1991) Experimental induction of heterotopic bone. Clin Orthop 263:102–112PubMed

11.

Elledge ES, Smith AA, McManus WF (1988) Heterotopic bone formation in burned patients. J Trauma 28:684–687PubMed

12.

Figgie MP, Inglis AE, Mow CS, Figgie HEI (1989) Total elbow arthroplasty for complete ankylosis of the elbow. J Bone Joint Surg Am 71:513–520PubMed

13.

Furman R, Nicholas JJ, Jivoff L (1970) Elevation of the serum alkaline phosphatase coincident with ectopic-bone formation in paraplegic patients. J Bone Joint Surg Am 52:1131–1137PubMed

14.

Garland DE, Razza BE, Waters RL (1982) Forceful joint manipulation in head-injured adults with heterotopic ossification. Clin Orthop 169:133–138PubMed

15.

Garland DE, Hanscom D, Keenan M, Smith C, Moore T (1985) Resection of heterotopic ossification in the adult with head trauma. J Bone Joint Surg Am 67:1261–1269PubMed

16.

Germann G, Wind G, Harth A (1999) Der DASH-Fragebogen—ein neues Instrument zur Beurteilung von Behandlungsergebnissen an der oberen Extremität. Handchir Mikrochir Plast Chir 31:149–152CrossRefPubMed

17.

Gosling T, Blauth M (2001) Bewegungseinschränkungen. In: Schmidt-Neuerburg KP, Letsch R, Towfigh H (eds) Ellenbogen, Unteram, Hand. Springer, Berlin Heidelberg New York, pp 107–134

18.

Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). The Upper Extremity Collaborative Group (UECG). Am J Ind Med 29:602–608CrossRefPubMed

19.

Ippolito E, Formisano R, Caterini R, Farsetti P, Penta F (1999) Resection of elbow ossification and continuous passive motion in postcomatose patients. J Hand Surg Am 24:546–553CrossRefPubMed

20.

Jäger M, Wirth CJ, Schmidt JM (1982) Arthrolyse und Arthroplastik am Ellbogengelenk. Hefte Unfallheilkd 155:265–273

21.

Lahoda LU, Klapperich T, Hahn MP, Muhr G (1999) Ergebnisse nach posttraumatischen Ellbogengelenkarthrolysen. Chirurg 70:1302–1306CrossRefPubMed

22.

Mansat P, Morrey BF (1998) The column procedure: a limited lateral approach for extrinsic contracture of the elbow. J Bone Joint Surg Am 80:1603–1615PubMed

23.

McKee MD, Kim J, Kebaish K, Stephen DJ, Kreder HJ, Schemitsch EH (2000) Functional outcome after open supracondylar fractures of the humerus. The effect of the surgical approach. J Bone Joint Surg Br 82:646–651CrossRefPubMed

24.

Michelsson JE, Rauschning W (1982) Pathogenesis of experimental heterotopic bone formation following temporary forcible exercising of immobilized limbs. Clin Orthop 176:265–272

25.

Moro JK, King GJW (2000) Total elbow arthroplasty in the treatment of posttraumatic conditions of the elbow. Clin Orthop 370:102–114

26.

Moro JK, Werier J, MacDermid JC, Patterson SD, King GJ (2001) Arthroplasty with a metal radial head for unreconstructable fractures of the radial head. J Bone Joint Surg Am 83:1201–1211

27.

Morrey BF (1990) Post-traumatic contracture of the elbow. J Bone Joint Surg Am 72:601–618PubMed

28.

Morrey BF (1993) Post-traumatic stiffness: distraction arthroplasty. In: Morrey BF (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 476–491

29.

Morrey BF, An KN, Chao EY (1993) Functional evaluation of the elbow. In: Morrey BF (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 86–97

30.

Munin MC, Balu G, Sotereanos DG (1995) Elbow complications after organ transplantation. Case reports. Am J Phys Med Rehabil 74:67–72PubMed

31.

O'Driscoll SW (1995) Arthroscopic treatment for osteoarthritis of the elbow. Orthop Clin North Am 26:691–706PubMed

32.

Oyemade GAA (1983) Fascial arthroplasty for elbow ankylosis. Int Surg 68:81–84PubMed

33.

Seth MK, Khurana JK (1985) Bony ankylosis of the elbow after burns. J Bone Joint Surg Br 67:747–749PubMed

34.

Sjoberg JO (1996) The stiff elbow. Acta Orthop Scand 67:626–631PubMed

35.

Timmermann LA, Andrews JR (1994) Arthroscopic treatment of posttraumatic elbow pain and stiffness. Am J Sports Med 22:230–235PubMed

36.

Urbaniak JR, Hansen PE, Beissinger SF, Aitken MS (1985) Correction of post-traumatic flexion contracture of the elbow by anterior capsulotomy. J Bone Joint Surg Am 67:1160–1164PubMed

37.

Viola RW, Hanel DP (1999) Early 'simple' release of posttraumatic elbow contracture associated with heterotopic ossification. J Hand Surg Am 24:370–380CrossRefPubMed

Title: Outcome assessment after arthrolysis of the elbow
Authors: T. Gosling
M. Blauth
T. Lange
M. Richter
L. Bastian
C. Krettek
Publication date: 01-05-2004
Publisher: Springer-Verlag
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 4/2004
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-003-0524-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Outcome assessment after arthrolysis of the elbow

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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