Comparative clinical outcomes and patient satisfaction in primary vs. revision total elbow arthroplasty

Total elbow arthroplasty has become a common surgical procedure. However, a certain percentage of patients may require revision due to unsatisfactory outcomes or complications. This study aimed to compare the clinical outcomes and patient satisfaction between primary and revision total elbow arthroplasty (TEA), considering factors such as etiology and causes for revision.

The study utilized a retrospective analysis of medical records from a cohort of 33 and 18 cases of primary and revision TEA, respectively, with a minimum follow-up of 2 years from the primary procedure. Clinical outcomes were assessed by measuring the Mayo Elbow Performance Score, Disabilities of the Arm, Shoulder and Hand score, range of motion, numeric rating scale, the Single Assessment Numeric Evaluation questionnaire, and patient satisfaction.

Significant differences were observed between primary and revision groups in the Mayo Elbow Performance Score (79.5 vs. 65.0), Disabilities of the Arm, Shoulder and Hand scores (32.6 vs. 53.7), and elbow range of motion (107.6° vs. 85.8°). The patients' subjective assessment via the numeric rating scale score, Single Assessment Numeric Evaluation score, and satisfaction did not show significant differences. The average numeric rating scale score was 1.6 for both groups; however, the Single Assessment Numeric Evaluation score (63 vs. 54) and patient satisfaction (4.0 vs. 4.1) were not significantly different between groups.

The clinical outcomes of primary vs. revision TEA were significantly worse in the revision group. Patient satisfaction scores were not different between the primary and revision groups despite differences in outcome scores, suggesting that revision patients may be satisfied with their outcomes despite lower clinical scores. These findings underscore the importance of considering both patient-reported outcomes and satisfaction levels in addition to objective clinical measures when evaluating the success of primary vs. revision TEA procedures.