Author
D. Eygendaal
Bio: D. Eygendaal is an academic researcher. The author has contributed to research in topics: Criterion validity & Functional ability. The author has an hindex of 1, co-authored 1 publications receiving 43 citations.
Topics: Criterion validity, Functional ability
Papers
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TL;DR: The EFA scale was found to be most suitable to measure elbow functional ability in RA, and was also shown to be highly reliable and practical in clinical practice.
Abstract: OBJECTIVES: (1) To investigate the measurement characteristics of the
Hospital for Special Surgery (HSS) and Mayo Clinic elbow assessment
instruments, utilizing methodological criteria including feasibility,
reliability, validity, and discriminative ability; and (2) to develop an
efficient and disease-specific rating system for elbow function assessment
(EFA) in adult patients with RA, using a combination of self-reported
subjective items and objective measures, and comparing its characteristics
with the HSS and Mayo Clinic scales. METHODS: (1) Selection of
elbow-specific items. (2) Investigation of reliability and validity of all
separate items, as well as the total HSS and Mayo Clinic scores, in 42
patients with RA (mean age 60 yrs). Direct observation of functional elbow
performance was defined as the gold standard against which criterion
validity was compared. (3) Reaching agreement within a team of
professionals on the different scale dimensions and the assigned weight.
(4) Item reduction by eliminating unreliable, inaccurate, unfeasible, and
ambiguous items. Finally, the EFA scale was constructed by selecting the
most reliable and accurate items. RESULTS: The EFA scale showed a superior
or equal degree of reliability as reflected in intraclass correlation
coefficients of more than 0.88, and also superior validity, compared with
the HSS and Mayo Clinic measures. CONCLUSION: Although the elbow scoring
systems currently available provide a reliable measure, they seem
restricted in evaluating elbow-specific functional ability. The EFA scale
was found to be most suitable to measure elbow functional ability in RA,
and was also shown to be highly reliable and practical in clinical
practice. (aut.ref.)
44 citations
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TL;DR: It may be advisable to evaluate pain separately from objective measures of elbow function in physician-based elbow ratings, as these measures may be strongly influenced by the psychosocial aspects of illness that have a strong relationship with pain, and objectives such as mobility may be undervalued.
Abstract: Background: Elbow function can be quantified with use of physician-based elbow-rating systems and health status questionnaires. Our hypothesis was that pain has a strong influence on these scores, which overwhelms the influence of objective factors such as motion.
Methods: One hundred and four patients were evaluated, at a minimum of six months (average, forty-six months) after the latest surgery for an intra-articular fracture of the elbow, with use of three physician-based evaluation instruments (Mayo Elbow Performance Index [MEPI], Broberg and Morrey rating system, and American Shoulder and Elbow Surgeons Elbow Evaluation Instrument [ASES]), an upper-extremity-specific health status questionnaire (Disabilities of the Arm, Shoulder and Hand [DASH]), and a general health status questionnaire (Short Form-36 [SF-36]). Multivariate analysis of variance and regression modeling were used to identify the factors that account for the variability in scores derived with these measures—in other words, which factors have the strongest influence on the final score.
Results: Pain alone accounted for 66% of the variability in the MEPI scores, 59% of the variability in the Broberg and Morrey scores, and 57% of the variability in the ASES scores. Models that included other factors accounted for only slightly more variability (73%, 79%, and 79%, respectively), and those that did not include pain accounted for only 22%, 41%, and 41% of the variability. Thirty-six percent of the variability in the DASH scores could be accounted for by pain alone, and 45% could be accounted for by pain and range of motion. Models not including pain accounted for only 17% of the variability in the DASH scores.
Conclusions: Pain has a very strong influence on both physician-rated and patient-rated quantitative measures of elbow function. Consequently, these measures may be strongly influenced by the psychosocial aspects of illness that have a strong relationship with pain, and objective measures of elbow function such as mobility may be undervalued. It may be advisable to evaluate pain separately from objective measures of elbow function in physician-based elbow ratings.
104 citations
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TL;DR: Arthroscopic capsular release of the elbow is a safe and reliable treatment for patients with a posttraumatic elbow contracture and can effective improve the elbow arc of motion.
94 citations
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TL;DR: Total elbow replacement is associated with a high complication rate and therefore may be warranted only for seriously disabled patients, and loosening of the humeral component remains a concern.
Abstract: BACKGROUND:
Total elbow arthroplasty is a well-established treatment for the painful elbow joint in patients with rheumatoid arthritis We present the results of what we believe to be the first prospective study of the Souter-Strathclyde total elbow prosthesis
METHODS:
Between June 1982 and December 2000, 204 primary total elbow prostheses were inserted in 166 patients who had rheumatoid arthritis No patient was lost to follow-up The mean duration of follow-up was 64 years All patients were examined preoperatively, at one and two years postoperatively, and at regular intervals thereafter
RESULTS:
Six of the 204 elbows had pain at rest at the time of the latest follow-up Ten patients (ten elbows) without previous neurological symptoms had development of paresthesias in the distribution of the ulnar nerve postoperatively Patients who had pain at rest or at night and those who had ulnar nerve symptoms preoperatively were found to have a significant chance of having the same complaints postoperatively Pain at rest or at night and a decrease in function during the follow-up period were associated with humeral loosening Twenty-four elbows had revision of the total elbow prosthesis because of loosening of the humeral component (ten), loosening after fracture (six), dislocation (four), infection (two), restricted range of motion (one), or fracture of the middle part of the humeral shaft, proximal to the prosthesis (one) One prosthesis was removed because of humeral loosening, and eight were removed because of deep infection Another five prostheses were radiographically loose at the time of the latest follow-up The rate of implant survival, according to the method of Kaplan-Meier, was 774% after ten years and 652% after eighteen years
CONCLUSIONS:
Total elbow replacement is associated with a high complication rate and therefore may be warranted only for seriously disabled patients Currently, the results associated with the Souter-Strathclyde total elbow prosthesis are comparable with the results associated with other prostheses, but loosening of the humeral component remains a concern
85 citations
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TL;DR: The Capitellocondylar and Souter–Strathclyde prostheses are the most-studied treatments for replacing the rheumatoid elbow and all TEP still have higher complication rates.
Abstract: Total elbow prosthesis (TEP) has been shown to be a viable option for treatment of the rheumatoid elbow. Many types of TEP have been studied, but the heterogeneity of the studies makes most conclusions subject to discussion. The aim of this systematic review is to show the differences between the most commonly used TEP for the destroyed rheumatoid elbow. After a search in Pubmed (NLM, Bethesda, USA) the senior author selected eight frequently used TEP: the Capitellocondylar, Coonrad-Morrey, GSB III, Kudo, Liverpool, Norway, Roper–Tuke and Souter–Strathclyde. For inclusion studies we arbitrarily formulated nine criteria , after which clearly adverse events were defined for comparison purposes. The Capitellocondylar and Souter–Strathclyde prostheses are the most-studied treatments for replacing the rheumatoid elbow. In contrast to the Capitellocondylar, the Souter–Strathclyde prosthesis showed higher loosening rates but implemented modifications of the design have reduced these rates in recent studies. Nevertheless, in relation to most other joint replacements in rheumatoid patients, all TEP still have higher complication rates. For this reason an elbow prosthesis may just be warranted in seriously disabled patients.
83 citations
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TL;DR: Recommendations for surgical treatment of radial head and neck fractures according to the Mason classification can now be given with the best available evidence.
Abstract: A B S T R A C T Introduction: There is no consensus on optimal treatment strategy for Mason type II-IV fractures. Most recommendations are based upon experts' opinion. Methods: An OVID-based literature search were performed to identify studies on surgical treatment of radial head and neck fracture. Specific focus was placed on extracting data describing clinical efficacy and outcome by using the Mason classification and including elbow function scores. A total of 841 clinical studies were identified describing in total the clinical follow-up of 1264
70 citations