Pain Relief and Psychological Reassurance Drive High Satisfaction, Underscoring the Importance of Patient-Reported Outcome Measures (PROMs)

AMC Professor In-Ho Jeon from the Department of Orthopedic Surgery “Must Consider Not Only Clinical Outcomes but Also Patients’ Emotions and Quality of Life.”

▲ Professor In-Ho Jeon from the Department of Orthopedic Surgery at Asan Medical Center is examining the range of motion in a patient’s elbow following total elbow arthroplasty (TEA)

Total elbow arthroplasty (TEA) is a surgical treatment typically performed on patients with severe elbow joint damage caused by conditions such as rheumatoid arthritis or trauma. Because the artificial joint must be implanted with precision to replace the damaged elbow, the procedure is highly complex, requiring careful consideration of bones, ligaments, and surrounding tissues.

Over time, complications such as infections at the surgical site or loosening of the prosthesis may necessitate revision surgery. These cases are particularly challenging, as the area has already undergone surgery, making the revision procedure more difficult and recovery of elbow function more limited compared to the initial operation.

A research team led by Professor In-Ho Jeon from the Department of Orthopedic Surgery at Asan Medical Center recently analyzed clinical outcomes in approximately 50 patients who underwent TEA. The study found that objective indicators such as range of motion and functional scores were higher in patients who underwent their first surgery. However, there was no significant difference between the primary and revision surgery groups in terms of patient-reported satisfaction and pain levels.

This is the first study in South Korea to demonstrate the importance of incorporating Patient-Reported Outcome Measures (PROMs), which reflect patients’ self-assessed health status, pain levels, quality of life, and other related factors, alongside objective clinical indicators measured by healthcare professionals in evaluating the outcomes of total elbow arthroplasty.

Professor In-Ho Jeon and his team compared outcomes from 51 patients (32 who underwent primary TEA and 19 who underwent revision surgery) who underwent TEA at Asan Medical Center between 2008 and 2021.

The results showed that the primary surgery group had a greater range of motion and higher functional scores of 107.6 degrees and 79.5 points, compared to that of revision group of 85.8 degrees and 65 points.

▲ Elbow pain (Photo: Getty Images)

However, when it came to patient-reported satisfaction and pain, both groups showed similar results. Satisfaction scores were 4.0 for the primary group and 4.1 for the revision group, while pain scores were identical at 1.6 for both groups.

These findings suggest that substantial pain reduction following revision surgery led to improvements in quality of life, while the psychological reassurance of not needing further procedures also contributed to greater patient satisfaction.

Professor In-Ho Jeon from the Department of Orthopedic Surgery at Asan Medical Center said “While demand for total elbow arthroplasty continues to rise with an aging population, scientific evidence regarding the effectiveness of revision surgeries has been limited. This study is significant in that it demonstrates improvement in pain and quality of life following revision surgery. When evaluating treatment outcomes, it is essential to consider not only objective metrics assessed by medical staff, but also patient-reported outcome measures (PROMs) that reflect patients’ emotions and daily functional recovery.”

The findings of this study were recently published in the ‘Journal of Shoulder and Elbow Surgery’ (impact factor: 2.9), the world’s leading journal in the field of shoulder and elbow.