Outcome assessment after arthrolysis of the elbow

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 101degrees for flexion/ extension with a relative gain of 60% and 134degrees 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.