Pain and Function in Patients with Rheumatic Disease and Elbow Arthroplasty: Clinical and Methodological Aspects

Abstract

Background More knowledge about the impact of elbow arthroplasty is needed. Objectives To describe pain and function in patients with elbow arthroplasty and to explore frequently used clinical- and patient-assessed measures for elbow function. Methods Pain and function [grip strength, range of motion (ROM)] were explored in a cross-sectional study of patients with elbow arthroplasty 1 year to 5 years after surgery. The properties of three outcome measures were assessed: the Disabilities of Arm, Shoulder and Hand questionnaire (Quick-DASH); the American Shoulder and Elbow Surgeons Elbow assessment form; and the Mayo Elbow Performance Score. For comparison, scales were transformed to 0 to 100. Correlations between measures and factors explaining patient-reported function (Quick-DASH) were explored. Results The study included 32 patients with a mean age of 68 years (75% females). Patients reported moderate level of pain (mean ± SD = 77), low arm function (Quick-DASH mean ± SD = 47), low grip strength (compared to norms) and limited ROM (flexion/extension arc less than 100°). Significant correlations with Quick-DASH were found for all measures (p < 0.01), except for ROM (p = 0.35). Grip strength contributed significantly (p = 0.03) to the variation in Quick-DASH, whereas ROM did not (p = 0.81). Conclusion Patients with elbow arthroplasty had moderate pain, but limited grip strength and ROM, 1 year to 5 years after surgery.