Determination of the patient acceptable symptomatic state after osteocapsular arthroplasty for primary elbow osteoarthritis.

BACKGROUND

The study aimed (1) to determine patient acceptable symptomatic state (PASS) values for the pain visual analog scale (PVAS), range-of-motion (ROM) scale difference, Mayo Elbow Performance Score (MEPS), and Self-evaluation Elbow (SEE) following osteocapsular arthroplasty for primary elbow osteoarthritis and (2) to determine factors for achieving the PASS.

METHODS

The study analyzed retrospectively collected osteocapsular arthroplasty registry data from January 2010 to April 2019. Fifty patients were evaluated, and anchor questions for deriving PASS values were administered at a 1-year follow-up. PASS values for the PVAS score, ROM difference, MEPS, and SEE score were derived using a sensitivity- and specificity-based approach. Univariate and multivariate logistic regression analyses were performed to determine factors for achieving the PASS. A subgroup comparison analysis based on age was also conducted.

RESULTS

The PASS value was 1.0 for the PVAS score, 15° for ROM difference, 75 for the MEPS, and 60 for the SEE score. Older age (≥65 years) showed significantly lower odds ratios for achieving the PASS for the PVAS score (0.888; 95% confidence interval, 0.804-0.981; P = .032) and ROM (0.861; 95% confidence interval, 0.760-0.976; P = .020).

CONCLUSION

Reliable PASS values were derived for the PVAS score, ROM difference, MEPS, and SEE score after osteocapsular arthroplasty. The PASS values defined in this study can be implemented as clinically relevant targets in patients undergoing osteocapsular arthroplasty. An analysis of factors that affect clinical symptom improvement showed that older age (≥65 years) was significantly correlated with lower PASS values for the PVAS score and ROM.