Can a Single Question Replace Patient-reported Outcomes in the Follow-up of Elbow Arthroplasty? A Validation Study

Overview

Journal J Orthop Traumatol

Specialties Emergency Medicine
Orthopedics

Date 2024 Oct 22

PMID 39438360

Authors

Arno A Macken

Ante Prkic

Iris Koenraadt-van Oost

Geert A Buijze

Bertram The

Denise Eygendaal

Affiliations

Soon will be listed here.

Abstract

Background: To assess the results after elbow arthroplasty it is essential to gather patient-reported outcome measures (PROMs). However, the acquisition of PROMs poses a challenge because of potential low literacy, lengthiness and diversity of questionnaires, and questionnaire fatigue. Instead of a questionnaire, patient-reported outcomes can be collected using a single assessment numeric evaluation (SANE), the subjective elbow value (SEV). The aim of this pilot study is to assess the correlation between the SEV and conventionally used patient reported outcome measures (PROMs) after elbow arthroplasty.

Materials And Methods: The SEV was added to our follow-up system in 2021, consisting of a scale from 0 to 10 in which the patients are asked to rate the overall functionality of their elbow, 0 corresponds to very poor functionality and 10 to a perfectly functional or healthy elbow. All patients who underwent elbow arthroplasty (total or radial head) and responded to the SEV question were retrospectively identified and included. The correlation between the SEV at the final follow-up and the Oxford Elbow Score (OES), and between the SEV and the Quick Disbailities of the Arm, Shoulder, and Hand (quickDASH) score was assessed using Pearson's r.

Results: In total, 82 patients responded to the SEV question and were included in the study, with a median follow-up of 5 years [interquartile range (IQR) 3-7]. Of these patients, 17 (21%) underwent radial head arthroplasty and 65 (79%) total elbow arthroplasty. The Pearson's r for the correlation between SEV and OES was 0.502 (p < 0.001) and between the SEV and the QuickDASH -0.537 (p < 0.001), which correspond to a moderate correlation.

Conclusions: The SEV shows a moderate correlation with conventional PROMs, demonstrating its potential in simplifying the follow-up of elbow arthroplasty, possibly decreasing time, costs, and patients' questionnaire fatigue compared with conventional PROM questionnaires.

Evidence Level: III.

References

Patel M, Kirsch J, Gutman M, McEntee R, Alberta F, Ramsey M . Single Assessment Numeric Evaluation Correlates with American Shoulder and Elbow Surgeons Score for Common Elbow Pathology: A Retrospective Cohort Study. Am J Sports Med. 2021; 49(10):2771-2777. DOI: 10.1177/03635465211024253. View

Baumgarten K . Can the Single Assessment Numeric Evaluation (SANE) be used as a stand-alone outcome instrument in patients undergoing total shoulder arthroplasty?. J Shoulder Elbow Surg. 2022; 31(9):e426-e435. DOI: 10.1016/j.jse.2022.02.036. View

Bhat M, Desai A, Patel V . Functional outcomes and complications following convertible primary total elbow arthroplasty: A single surgeon series. Shoulder Elbow. 2022; 14(3):304-316. PMC: 9121287. DOI: 10.1177/1758573221991511. View

Nolte P, Vorm Walde M, Elrick B, Grutzner P, Porschke F, Schnetzke M . High return to sport rate and good patient-reported outcomes in recreational athletes following simple elbow dislocations. J Orthop Surg Res. 2023; 18(1):453. PMC: 10290408. DOI: 10.1186/s13018-023-03914-2. View

Schneeberger A, Kosters M, Steens W . Comparison of the subjective elbow value and the Mayo elbow performance score. J Shoulder Elbow Surg. 2014; 23(3):308-12. DOI: 10.1016/j.jse.2013.11.018. View

Engelke J, Vorm Walde M, Schnetzke M, Grutzner P, Nolte P . High correlation of the subjective elbow value with Mayo Elbow Performance Score and Oxford Elbow Score in patients with elbow dislocation. JSES Int. 2023; 7(5):868-871. PMC: 10499643. DOI: 10.1016/j.jseint.2023.04.010. View

Gathen M, Ploeger M, Peez C, Weinhold L, Schmid M, Wirtz D . Comparison of the Subjective Elbow Value with the DASH, MEPS und Morrey Score after Olecranon Fractures. Z Orthop Unfall. 2019; 158(2):208-213. DOI: 10.1055/a-0946-2649. View

Gilbart M, Gerber C . Comparison of the subjective shoulder value and the Constant score. J Shoulder Elbow Surg. 2007; 16(6):717-21. DOI: 10.1016/j.jse.2007.02.123. View

Kerschbaum M, Thiele K, Scheibel M, Gerhardt C . Residual increased valgus stress angulation and posterolateral rotatory translation after simple elbow dislocation. Knee Surg Sports Traumatol Arthrosc. 2016; 25(7):2298-2303. DOI: 10.1007/s00167-016-4176-0. View

10.

Orgel M, Graulich T, Liodakis E . [Single Assessment Numeric Evaluation (SANE)-a promising and valid measuring tool related to patient-reported outcome measures (PROM)]. Orthopade. 2021; 51(4):333-336. PMC: 8969039. DOI: 10.1007/s00132-021-04190-w. View

11.

Nazari G, MacDermid J, Bobos P, Furtado R . Psychometric properties of the Single Assessment Numeric Evaluation (SANE) in patients with shoulder conditions. A systematic review. Physiotherapy. 2020; 109:33-42. DOI: 10.1016/j.physio.2020.02.008. View

12.

Razaeian S, Wiese B, Zhang D, Krettek C, Meller R, Hawi N . Correlation between Oxford Elbow Score and Single Assessment Numeric Evaluation: Is one simple question enough?. J Shoulder Elbow Surg. 2020; 29(6):1223-1229. DOI: 10.1016/j.jse.2020.01.067. View

13.

Lanzerath F, Hochberger F, Ott N, Hackl M, Wegmann K, Muller L . Anteromedial coronoid facet fractures and associated ligament lesions: A case series. Injury. 2023; . DOI: 10.1016/j.injury.2023.04.026. View

14.

Claessen F, Mellema J, Stoop N, Lubberts B, Ring D, Poolman R . Influence of Priming on Patient-Reported Outcome Measures: A Randomized Controlled Trial. Psychosomatics. 2015; 57(1):47-56. DOI: 10.1016/j.psym.2015.09.005. View

15.

Broekman M, Brinkman N, Swanson D, Ring D, van den Bekerom M, Jawa A . Variations in 1-year Trajectories of Levels of Pain and Capability After Shoulder Arthroplasty Are Associated With Baseline Mental Health. Clin Orthop Relat Res. 2023; 482(3):514-522. PMC: 10871746. DOI: 10.1097/CORR.0000000000002821. View

16.

Arrigoni P, Cucchi D, DAmbrosi R, Menon A, Aliprandi A, Randelli P . Arthroscopic R-LCL plication for symptomatic minor instability of the lateral elbow (SMILE). Knee Surg Sports Traumatol Arthrosc. 2017; 25(7):2264-2270. DOI: 10.1007/s00167-017-4531-9. View

17.

Jonsson E, Wanstrom J, Bjornsson Hallgren H, Adolfsson L . The Oxford Elbow Score demonstrated good measurement properties when used with a shortened 7-day recall period. JSES Int. 2023; 7(3):499-505. PMC: 10229418. DOI: 10.1016/j.jseint.2022.12.023. View

18.

Paul R, Gupta R, Zareef U, Lopez R, Erickson B, Kelly 4th J . Similar return to sport between double cortical button and docking techniques for ulnar collateral ligament reconstruction in baseball players. J Shoulder Elbow Surg. 2023; 33(2):366-372. DOI: 10.1016/j.jse.2023.07.045. View

19.

Thigpen C, Shanley E, Momaya A, Kissenberth M, Tolan S, Tokish J . Validity and Responsiveness of the Single Alpha-numeric Evaluation for Shoulder Patients. Am J Sports Med. 2018; 46(14):3480-3485. DOI: 10.1177/0363546518807924. View

20.

Ernstbrunner L, Hingsammer A, Imam M, Sutter R, Brand B, Meyer D . Long-term results of total elbow arthroplasty in patients with hemophilia. J Shoulder Elbow Surg. 2017; 27(1):126-132. DOI: 10.1016/j.jse.2017.09.009. View