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British Medical Bulletin Advance Access originally published online on June 6, 2008
British Medical Bulletin 2008 87(1):131-161; doi:10.1093/bmb/ldn023
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© The Author 2008. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Rating systems for evaluation of the elbow

Umile Giuseppe Longo{dagger}, Francesco Franceschi{dagger}, Mattia Loppini{dagger}, Nicola Maffulli*,{ddagger} and Vincenzo Denaro{dagger}

{dagger} Department of Orthopaedic and Trauma Surgery, Campus Biomedico University, Via Alvaro del Portillo, 200, 00128 Trigoria Rome, Italy
{ddagger} Department of Trauma and Orthopaedic Surgery, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke-on-Trent ST4 7LN, UK

* Correspondence to: Nicola Maffulli, Department of Trauma and Orthopaedic Surgery, University Hospital of North Staffordshire, Keele University School of Medicine, Stoke-on-Trent ST4 7LN, UK. E-mail: osa14{at}keele.ac.uk

Introduction: Many scoring systems have been used for elbow disorders. However, only few of these have been validated, and many assess only few aspects of elbow function.

Methods: A literature search was performed using the keyword ‘elbow’ in combination with ‘scoring system’, ‘outcome assessment’, ‘elbow disorder’ and ‘clinical evaluation’.

Results: Eighteen scoring systems are currently available for the evaluation of elbow disorders. Each of them evaluates the elbow performance using specific variables, including both objective and subjective criteria. All these scoring systems are presented.

Discussion: Although many scoring systems have been used to evaluate elbow function, we are still far from a single outcome evaluation system which is reliable, valid and sensitive to clinically relevant changes, takes into account both patients' and physicians' perspective and is short and practical to use.

Conclusion: Further studies are required to evaluate the reliability, validity and sensitivity of the elbow scoring systems used in the common clinical practice.

Keywords: elbow • scoring system • outcome assessment • clinical evaluation • arthroscopy

Accepted for publication May 13, 2008.


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