OrthopedicsMayo Elbow Performance Score
Pain Assessment
Range of Motion
0 ptsStability
0 ptsDaily Function
Clinic Scored Outcome
Calculated MEPS
0
/ 100Poor Outcome
Score Breakdown
Pain
0/ 45
ROM
0/ 20
Stability
0/ 10
Function
0/ 25
Score interpretation based on Morrey et al. Excellent outcomes correlate with high patient satisfaction and functional restoration.
Guidelines & Evidence
Verified
Last Review: 2026
When to Use
When to Use MEPS
Post-operative evaluation after total elbow arthroplasty (TEA) for rheumatoid arthritis, post-traumatic arthritis, or distal humerus fracture
Outcome assessment after open reduction internal fixation (ORIF) of distal humerus fractures (intercondylar, supracondylar, capitellar shear fractures)
Evaluation of complex elbow instability (terrible triad: radial head fracture + coronoid fracture + posterior dislocation; varus posteromedial rotatory instability; posterolateral rotatory instability) after ligament reconstruction or fracture fixation
Follow-up after elbow fracture-dislocation: transolecranon fracture-dislocations, Monteggia fractures, complex radial head fractures (Mason type III-IV)
Assessment of elbow contracture release (open or arthroscopic capsular release, distraction arthroplasty) outcomes
Monitoring of elbow osteoarthritis after debridement, interposition arthroplasty, or total elbow arthroplasty
Clinician-scored objective measure (not patient-reported — use Oxford Elbow Score or DASH for patient-reported outcomes; MEPS complements these)
Research endpoint for elbow surgery clinical trials (most common elbow-specific outcome measure in orthopaedic literature)
MEPS vs Other Elbow Outcome Scores — Comparison
| Score | Type (Clinician vs Patient) | Domains | Score Range | Administration Time (min) | Advantages | Disadvantages |
|---|---|---|---|---|---|---|
| MEPS (Mayo Elbow Performance Score) | Clinician-scored (combined objective + subjective) | Pain (45 pts), ROM (20 pts), Stability (10 pts), Function (25 pts — 5 ADLs) | 0-100 (Excellent 90-100, Good 75-89, Fair 60-74, Poor < 60) | 3-5 minutes | Objective (ROM, stability) reduces patient response bias; pain heavily weighted (45%) reflects clinical importance; widely used in elbow arthroplasty and trauma literature; correlates with DASH (r=0.75) and Oxford Elbow Score (r=0.72) | Less patient-centered (no questions about recreation, work, social function); function domain limited to 5 basic ADLs (not sports, heavy lifting, overhead work); ROM scoring arc >100° gives full points (misses subtle restrictions) |
| Oxford Elbow Score (OES) | Patient-reported (PROM, 12 items) | Pain (20-60), function (17-60), social-psychological (13-60) — 3 domains | 0-48 (raw sum, converted to 0-100 scale, higher better) | 5-8 minutes | Validated for elbow arthroplasty and trauma; responsive to change; recommended by British Elbow Society; no clinician bias; includes psychological/social domains | Requires patient literacy; not as widely used in US as MEPS; no objective component (cannot detect subtle instability or motion loss) |
| DASH (Disabilities of Arm, Shoulder, Hand) | Patient-reported (30 items core + optional modules) | Upper extremity function (not elbow-specific, whole arm) | 0-100 (0=no disability, 100=severe disability) | 10-15 minutes | Validated for all upper extremity conditions; useful for comparing elbow to shoulder/hand pathology; widely used and translated | Not elbow-specific (may miss elbow-specific issues like instability, catching, clicking); longer administration time |
| PREE (Patient-Rated Elbow Evaluation) | Patient-reported (20 items) | Pain (0-50), function (0-50, with ADL and personal care subdomains) | 0-100 (higher=worse) | 5-8 minutes | Elbow-specific PROM; simpler than OES; valid for trauma and arthritis; responsive to change | Less validated than MEPS and OES; no advantage over OES in head-to-head comparisons |
| Brostrom Score (elbow instability) | Clinician-scored (ligament-specific) | Instability grading, pain, ROM, strength, function (10 ADLs) | 0-100 (Brostrom classification: excellent >90, good 75-89, fair 60-74, poor < 60 — similar to MEPS) | 5 minutes | Specific for elbow instability (medial/lateral collateral ligament injury); includes stability testing, strength, sports function | Not validated for arthritis or arthroplasty; less widely used than MEPS |
What MEPS Does NOT Measure (Limitations)
Patient satisfaction with appearance (scar, elbow contour, surgical incision healing) — may be important to patients, especially young women after elbow arthroplasty
Sports or high-demand activities (golf, tennis, weightlifting, pitching, gymnastics, wrestling) — MEPS only measures basic ADLs (combing hair, feeding, hygiene, shirt, shoe)
Work-related function (heavy lifting > 50 lbs, repetitive overhead work, vibration tools) — important for workers' compensation and return to work prediction
Neurologic function (ulnar neuropathy common after elbow trauma and arthroplasty) — MEPS does not assess numbness, tingling, Froment sign, clawing, or intrinsic muscle weakness
Strength (grip strength, pronation/supination torque, flexion/extension strength) — objective strength testing requires dynamometer, not included
Instability in high-demand activities (MEPS tests passive varus/valgus stability only; does not assess dynamic stability during throwing, push-ups, or heavy lifting)
Scoring subjectivity: "moderate pain with activity" (30 points) vs "severe pain" (15 points) — ambiguous thresholds, inter-observer variability (ICC 0.65-0.75)
Last Comprehensive Review: 2026