Responsiveness of the Liverpool Elbow Score in elbow arthroplasty (original) (raw)

2013, Journal of Shoulder and Elbow Surgery

Background: Total elbow arthroplasty (TEA) is increasingly used for the treatment of advanced elbow conditions to reduce pain and improve function. However, TEA is still associated with a higher complication rate compared to the total hip and knee arthroplasty despite advances in the design and surgical techniques. This prospective clinical study reports the outcome of the Discovery Elbow System (Biomet Inc., Warsaw IN, USA) system which has been in clinical use in the UK since 2003. Methods: The study included a total of 100 Discovery elbows (April 2003 to January 2010) with a minimum 2-year follow-up including 75 primary and 25 revisions (60 % females and 40% males; mean age, 62 years). Outcome was assessed by means of Liverpool Elbow Score, pain experience, patient satisfaction, range of movement, and radiographic imaging. Results: Mean follow-up was 48.5 months (range: 24-108 months). Liverpool Elbow Score improved from 3.79 to 6.36 (P<.001). Pain-free patients were substantially increased form 7% preoperatively to 64% at the final follow-up. Patient satisfaction rate was over 90%. The arc of flexion-extension and pronation-supination increased from 72º to 93º and from 86º to 111º, respectively (P<.001). Major post-operative complications included deep infection (2%), progressive aseptic loosening requiring revision (primary, 5%; revision 12%), persistent ulnar neuropathy (3%), and periprosthetic fracture (primary, 6.8%; revision, 8%). Conclusion: Discovery elbow resulted in improved function, reduced pain, and high patient satisfaction. Long-term results are required for assessing the survivorship of this system.