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Mayo Elbow Score Calculator

Mayo Elbow Performance Score

The Mayo Elbow Performance Score is a 100-point examiner-completed rating of the elbow that combines 45 points for pain, 20 for arc of motion, 10 for stability and 25 for five daily tasks, graded excellent at 90 or above, good at 75 to 89, fair at 60 to 74 and poor below 60.

Free to use8 items~3 min0–100, higher is better

Pain (45 points)

Record the patient’s usual level of elbow pain.

1Pain

Motion (20 points)

Measure the arc of flexion with a goniometer — the extension deficit subtracted from the flexion reached.

2Arc of motion

A 100° arc, from about 30° to 130° of flexion, is the functional arc described by Morrey and colleagues in 1981.

Stability (10 points)

Assess varus–valgus stability clinically.

3Stability

Many series define moderate instability as less than 10° of varus–valgus laxity and gross instability as more than 10°.

Function (25 points)

Five daily tasks, worth 5 points each. Record whether the patient can do each one.

4Can the patient comb their hair?
5Can the patient feed themselves?
6Can the patient perform personal hygiene tasks?
7Can the patient put on a shirt?
8Can the patient put on shoes?

What the Mayo Elbow Score means

Mayo Elbow Score scores run from 0 to 100, where a higher score is better. The bands below are conventional reporting categories, not diagnostic cut-offs.

  • Poor0–59
  • Fair60–74
  • Good75–89
  • Excellent90–100

How the score is calculated

Stated in full so the calculation can be independently checked, and reproduced by hand if needed.

Four components are added to a maximum of 100. Pain contributes 45 points (none 45, mild 30, moderate 15, severe 0). Arc of motion contributes 20 points (more than 100° 20, 50° to 100° 15, less than 50° 5). Stability contributes 10 points (stable 10, moderate instability 5, gross instability 0). Function contributes 25 points as five tasks of 5 points each — combing the hair, feeding oneself, personal hygiene, putting on a shirt and putting on shoes — scoring 5 if the patient can do the task and 0 if not. A higher total is better. The total is graded excellent at 90 to 100, good at 75 to 89, fair at 60 to 74 and poor below 60. Because the five tasks are worth 5 points each, totals fall on multiples of 5.

Missing data

There is no imputation rule. Every component must be assessed for the total to be valid. Unanswered items contribute zero in the calculator above, which understates the score — a partial figure is shown only so the entry can be checked, and must not be graded.

Instrument profile

Developer
Bernard F. Morrey, Kai-Nan An and Edmund Y. S. Chao
Institution
Mayo Clinic, Rochester, United States
First published
1993
Custodian
No active custodian; published in the textbook The Elbow and Its Disorders
Items
8
Response format
Three graded items and five yes-or-no daily tasks
Score range
0 to 100
Direction
Higher score = better
Recall period
Current status at the time of examination
Completion time
About 3 minutes
Age range
Adults
Regions
Elbow
Conditions
Post-traumatic elbow arthritis, Distal humerus fracture, Radial head fracture, Elbow instability, Rheumatoid arthritis of the elbow, Elbow stiffness
Procedures
Total elbow arthroplasty, Distal humerus fixation, Radial head arthroplasty, Elbow arthroscopy, Elbow capsular release, Elbow ligament reconstruction
Languages
English
Observer agreement
Not established by the developers. Later independent studies have examined agreement between observers; the published figures vary and are not reproduced here.
Validity
The weights were assigned by expert consensus rather than derived from patient data, and the index was never put through the item-generation and validation steps that current standards require.
Reliability
Widely used to report change after elbow surgery, but with no established minimal clinically important difference a change of a given number of points cannot be called meaningful.
Ceiling effect
Present. Because pain carries almost half the points and the five daily tasks are easy ones, a patient with a painless elbow and a modest arc can still reach the good or excellent grade.
Floor effect
Uncommon.

When to use the Mayo Elbow Score

Well suited to

  • Reading and comparing the elbow literature, particularly total elbow arthroplasty and post-traumatic reconstruction series, many of which report MEPS.
  • Continuing a long-running series or registry that has collected the score from the start.

Limitations and poor fits

  • Choosing a patient-reported primary outcome for a new study — use a validated patient-reported elbow measure such as the Oxford Elbow Score or the Patient-Rated Elbow Evaluation, with the QuickDASH for the upper limb as a whole.
  • Postal, telephone or electronic follow-up: arc of motion and stability require a physical examination.
  • Judging whether an individual patient has improved meaningfully, since no minimal clinically important difference has been established.
  • Comparing outcomes across series without checking how stability was graded, which the original table leaves to the examiner.

Mayo Elbow Score compared with other instruments

Instruments measuring a related construct, with the practical difference between them.

InstrumentItemsRangeWhat it adds
QuickDASH110–100The QuickDASH is an 11-item shortened form of the DASH that measures physical function and symptoms across the whole upper limb on a single 0 to 100 scale, where a higher score means greater disability.
Mayo Wrist Score40–100The Mayo Wrist Score is a 100-point rating of the wrist made of four equal parts — pain, functional status, range of motion and grip strength, 25 points each — with the last two expressed as a percentage of the opposite wrist, and it is graded excellent at 90 or above through to poor below 60.
Mason21–4The Mason classification sorts radial head fractures into four types — non-displaced (I), displaced partial articular (II), comminuted involving the whole head (III), and any radial head fracture accompanied by an elbow dislocation (IV) — and the type broadly separates fractures managed non-operatively from those needing fixation or replacement.
Gartland21–4The Gartland classification grades extension-type supracondylar humerus fractures in children as type I when non-displaced, type II when angulated with the posterior cortex intact, type III when completely displaced with no cortical contact, and type IV when the fracture is unstable in both flexion and extension — a diagnosis that can only be made under fluoroscopy in theatre.

Copyright and permitted use

Published openly because it is the question every clinician and researcher asks before using an instrument, and almost nobody answers it.

Free to use

A rating table published in a textbook chapter and reproduced throughout the elbow literature, with no licensing programme known to us. We have not approached the Mayo Clinic or the publisher, so we cannot say the table is free of copyright; if a rights holder objects, the page will be changed.

References

  1. Morrey BF, An KN, Chao EYS. Functional evaluation of the elbow. In: Morrey BF, ed. The Elbow and Its Disorders, 2nd ed. Philadelphia: WB Saunders. 1993.
  2. Morrey BF, Askew LJ, Chao EY. A biomechanical study of normal functional elbow motion. Journal of Bone and Joint Surgery (American volume). 1981.

Editorial status

Not yet reviewedQueued for clinical review by Sam Tuffun, PT, DPT. Sign-off has not taken place — this is a placeholder assignment, not a completed review.