Global Functional Evaluation of Elbow after Radial Head Prosthesis: Isokinetic Testing Interest and Validation - Abstract
Background: Strength and mobility evaluation through isokinetic testing is popular for knee readaptation, but this type of parameter is not sufficiently studied for elbow recovery. However, functional usual elbow scores mostly attach importance to pain and subjective answers. Including a new objective parameter could help for global elbow evaluation after surgery or elbow traumatism. Objectives: The purpose of this study was to assess isokinetic elbow evaluation on patients with radial head prosthesis, after severe radial head fracture and elbow traumatism, and compare results with standard functional and clinical evaluation. Methods: Eighteen volunteer patients with radial head prosthesis at a mean follow-up of 73,3 months were evaluated clinically and functionally by a first examinator (pain, MEPI-score, quick-DASH score and elbow ranges-of-motion). A second examinator performed a blinded isokinetic evaluation. Results were gathered for analysis. Complete and detailed protocol for isokinetic elbow evaluation is presented for extensor and flexor torque.Results: A 42% of patients kept pain for heavy work or climatic changes. MEPI mean score was 85,2 and quick-DASH score was 22,9%. All ranges of motion were reduced compared to uninjured side. For isokinetic testing, extensor and flexor torque were respectively of 49,2Nm and 40,3Nm at slow motion, and 47,6Nm and 46,7Nm for fast motion. All those parameters were also reduced compared to uninjured side. Statistical analysis didn’t find any correlation between functional scores and isokinetic testing. Conclusion: This study confirms that isokinetic elbow evaluation is feasible, with detailed protocol. This parameter brings new data for evaluationsince no correlation is found with standard functional scores. This new and objective tool should be more developed for global elbow evaluation. After sever elbow traumatisms, results of isokinetic evaluation could here explain why patients keep discomfort for heavy work or sporting activities.