Elbow joint position sense after total elbow arthroplasty

Background: Multiple human experiments have shown that articular lesions can have a negative effect on proprioception. The influence of total elbow arthroplasty on joint position sense has not been reported so far. The purpose of the study was to evaluate proprioception, defined as a joint position sense, after total elbow arthroplasty. Methods: The study included 16 patients with unilateral semiconstrained linked total elbow arthroplasty and 21 healthy volunteers. The evaluation included measurement of active and passive reproduction of joint position sense of both elbows after surgery and the control groups. Reference angles included extension to 50 degrees and 70 degrees and flexion to 110 degrees. We also assessed function of the elbow in arthroplasty group using the Mayo Elbow Performance Score, the Disability of theArm, Shoulder and Hand score, and a visual analog scale for pain level. Results: The average value of error of passive reproduction of joint position for elbows after arthroplasty was significantly inferior for all evaluated positions compared with the contralateral elbow and with the control group, respectively, at 110 degrees flexion: 4.3 degrees, 2.7 degrees, and 3.2 degrees; at 70 degrees extension: 4.9 degrees, 2.9 degrees, and 2.7 degrees; and at 50 degrees extension: 6.3 degrees, 3.8 degrees, and 3.8 degrees. The average value of error of active reproduction of joint position for the arthroplasty group was also significantly inferior, respectively, at 110 degrees flexion: 3.5 degrees, 1.9 degrees and 2 degrees; and at 50 degrees extension: 4.4 degrees, 3.3 degrees, and 3 degrees. Conclusion: Proprioception in elbows that undergo total arthroplasty is significantly inferior compared with the contralateral site of the patient and in the healthy control group. (C) 2014 Journal of Shoulder and Elbow Surgery Board of Trustees.