Effect of hyperuricemia on functional outcomes and complications in patients with elbow stiffness after open arthrolysis combined with hinged external fixation: a retrospective study.

Abstract

BACKGROUND:

Hyperuricemia is considered a risk factor for increased postoperative complications and adverse functional outcomes in a variety of orthopedic surgeries. The purpose of this retrospective study was to investigate the clinical efficacy of patients with different uric acid levels after elbow arthrolysis.

METHODS:

The study included 131 patients with post-traumatic elbow stiffness who underwent arthrolysis between March 2014 and March 2016. All patients were divided into 4 groups based on the preoperative serum level of uric acid (UA). The quartile method was used for grouping patients, including 33 in Q1 (UA <293 μmol/L), 34 in Q2 (293-348 μmol/L), 32 in Q3 (348-441 μmol/L), and 32 in Q4 (441-710 μmol/L). At baseline and each time point of follow-up, functional performance, Mayo Elbow Performance Score, visual analog scale for pain, and complications were evaluated.

RESULTS:

Preoperative data were not significantly different among the 4 groups (Q1, Q2, Q3, and Q4). At the final follow-up, the following data showed significant differences among the 4 groups: extension (P = .031), flexion (P = .008), range of motion (P = .003), Mayo Elbow Performance Score (P = .011), and visual analog scale (P = .032). Interestingly, patients in the Q4 group had the poorest clinical outcomes. However, no significant differences were found among the 4 groups in new onset or exacerbation of nerve symptoms (P = .919), reduced muscle strength (P = .536), instability (P = .567), or infection (P = .374) at the last follow-up.

CONCLUSION:

This study confirms that in patients with post-traumatic elbow stiffness, abnormal serum uric acid metabolism was a risk factor for poor performance and postoperative pain after arthrolysis. Therefore, detecting the preoperative serum uric acid levels of the patients would be helpful for evaluating the postoperative outcomes.

• Authors: Hao Xiong, Ziyang Sun, Shuai Chen, Wenjun Liu, Shiqiao Peng, Wei Wang, Cunyi Fan
• Journal: Journal of shoulder and elbow surgery (J Shoulder Elbow Surg) Vol. 29 Issue 7 Pg. 1387-1393 (Jul 2020) ISSN: 1532-6500 [Electronic] United States
• PMID: 32553439 (Publication Type: Journal Article)
• Copyright: Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.

Chemical References

• Uric Acid

Topics

• Adult
• Elbow Joint (physiopathology, surgery)
• External Fixators
• Female
• Humans
• Hyperuricemia (blood, physiopathology)
• Joint Diseases (etiology, physiopathology, surgery)
• Male
• Middle Aged
• Pain Measurement
• Pain, Postoperative (blood, etiology)
• Range of Motion, Articular
• Retrospective Studies
• Risk Factors
• Treatment Outcome
• Uric Acid (blood)
• Young Adult
• Elbow Injuries