Clinical Outcomes After Posterior Open Elbow Arthrolysis for Posttraumatic Elbow Stiffness

Background: Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past. Objectives: The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients’ quality of life. Patients and Methods: During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients. Results: Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion. Conclusions: According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients’ quality of life

Depression, anxiety and quality of life in caregiver spouses of veterans with chronic spinal cord injury

Objective: We were curious about the degree of anxiety and depression and their effect on the quality of life of the caregivers of veterans with spinal cord injury (SCI). Methods: A convenience sample of 72 out of 120 caregiver spouses of veterans with spinal cord injury participated in our study. The Hospital Anxiety and Depression Scale (HADS) were considered as a measure of depression and anxiety. The World Health Organization Quality of Life BREF questionnaire (WHOQOL-BREF) was considered to evaluate the quality of life. To compare the caregivers, we enrolled 74 matched caregiver spouses of patients without spinal cord injury. Results: The average age of the spouses was 44.7±6.5. The average time elapsed from the injury was 26.4±3.1 years. There was a significant difference in all domains of quality of life and depression between the caregivers and the control group, but there was not a significant difference in terms of anxiety. There was a negative correlation between depression and age, level of education and quality of life. Conclusion: Mental care support should be implemented for veterans and their spouses in addition to the provided facilities

Cross-Cultural Adaptation and Validation of the Persian Version of the Oxford Knee Score in Patients with Knee Osteoarthritis

Background: The Oxford Knee Score (OKS) is a short patient-reported outcome instrument that measures pain and physical activity related to knee osteoarthritis. The purpose of this study is to evaluate, construct validity and consistent reliability of the Persian version of the OKS. Methods: The case series consisted of 80 patients who were clinically diagnosed with having knee osteoarthritis. All patients were requested to fill-in the Persian OKS and Short-Form 36 Health Survey (SF-36). Correlation analysis between the Persian versions of these two instruments was then carried out. The scores of the Persian SF-36 were used to evaluate convergent and divergent validity of the 12-item Persian OKS. Results: From a total of 80 patients, 63 were female (79%) and the remaining 17 were male (21%) with a mean age of 52.2 years. In the present study, high Cronbach’s alpha of 0.95 confirms excellent internal consistency of the Persian OKS scale similar to previous investigations. The results confirm that the Persian version of this instrument is valid and reliable, similar to its English index and its subsequent translations in different languages. Conclusion: The Persian OKS is a reliable instrument to evaluate knee function in patients with knee osteoarthritis and is a useful tool for outcome measurement in clinical research

The spinal cord injury quality-of-life-23 questionnaire, Iranian validation study

Background: The spinal cord injury quality-of-life questionnaire (SCIQL-23) is an instrument that has been developed for clinical follow-up as well health related quality-of-life (QOL) measurement in people with spinal cord injury (SCI). The purpose of this study was to assess the validity and reliability of the Persian version of SCIQL-23 in individuals with chronic SCI. Materials and Methods: Medical outcomes study 36 item short-form health survey (SF-36) as well as the Persian version of the SCIQL-23 questionnaires applied to be used in 52 veterans with spinal cord injuries in the Orthopedic Research Center, Mashhad University of Medical Sciences from January 2011 to August 2011. Cronbach′s alpha co-efficient computed to test the reliability of the survey. In order to assess the convergent validity the correlation of each item of the SCIQL-23 done with each dimension of the SF-36 by applying the Pearson correlation co-efficient. Independent samples t-test used to test power of discrimination. Results: All of veterans were male and married. The mean age of individuals at the time of interview was 49.3 years (standard deviation = 7.9); in a range between 38 and 80 years. Most of them (88.5%) had incomplete paraplegia. Cronbach′s alpha test revealed strong reliability in questions of SCI QOL (Total Cronbach′s alpha = 0.764). A negative significant correlation occurred between physical function and functioning (FUNC) (r = −0.412FNx08), bodily pain and problems related to injury (PROB) (r = −0.313FNx01), vitality (VT) and mood state (MOOD) (r = −0.327FNx01), social function and PROB (r = −0.309FNx01), mental health (MH) and MOOD (r = −0.406FNx08). Furthermore, the Mental component summary (MCS) of SF-36 had a negative significant correlation with MOOD (r = −0.312FNx01). Similar to MCS, physical component summery (PCS) had a negative significant correlation with MOOD (r = −0.276FNx01) in addition to FUNC (r = −0.324FNx01) and PROB (r = −0.318FNx01). Instead, GH (r = 0.455FNx08), VT (r = 0.322FNx01), MH (r = 0.276FNx01) and PCS illustrated a positive significant correlation with global quality of life. Conclusion: The Persian version of the SCQL-23 discovered to be competent in terms of its valuable psychometric properties in assessing the QOL of SCI people by showing excellent internal consistency and no floor or ceiling effect