A registry based analysis of the patient reported outcome after surgery for trapeziometacarpal joint osteoarthritis

Abstract

Background: The aim of the study was to evaluate patient reported outcome measures (PROM) before and after trapeziectomy with or without ligament reconstruction and tendon interposition for trapeziometacarpal joint arthritis with special focus on possible differences due to gender, age and surgical method. Methods: Data from the Swedish quality registry for hand surgery (HAKIR) was analyzed preoperatively, 3 months and 1 year postoperatively for 1850 patients (mean age 63 years, 79% women). Results: One year postoperatively, mean pain at rest was reduced from 50 to 12 of maximum 100. However, pain on load and weakness had not abated to the same extent (mean 30 and 34 of 100, respectively). The mean improvement in PROM did not differ between age groups or gender. The result was similar after trapeziectomy with ligament reconstruction and tendon interposition (86% of the patients) and simple trapeziectomy but few patients were operated with the latter method. Conclusion: Pain on load and weakness remains to some extent 1 year after surgery for trapeziometacarpal joint arthritis. The result is similar after trapeziectomy with or without ligament reconstruction and tendon interposition and the same improvement can be expected after surgery regardless of age and gender.

Socioeconomic factors predicting outcome in surgically treated carpal tunnel syndrome: a national registry-based study

“…The approximately one third response rate in HAKIR during the study period may have impacted on the representativeness of the data, thereby affecting interpretation. The response rate was at the same level as previously reported 10,29,30 , with no clear explanation for attrition. Response rates have improved over time since HAKIR started in 2010, but further improvement is needed.…”

Construct validity, floor and ceiling effects, data completeness and magnitude of change for the eight-item HAKIR questionnaire: a patient-reported outcome in the Swedish National Healthcare Quality Registry for hand surgery

“…For instance, pain is the symptom causing disability for patients with thumb osteoarthritis and is therefore the main indication for surgery. 17 A large ES at 12 months follow-up for all included pain questions (item 1-3) in HQ-8, as well as the question concerning ability to perform daily activities, was therefore as expected. Another example of expected ES is the improvement of numbness/tingling in fingers (item 6) following a carpal tunnel release.…”

Outcomes and recommendations for revision of thumb carpometacarpal resection arthroplasty

“…We were able to define a revision algorithm that can be used as a decisionmaking aid when a patient presents with residual symptoms after resection arthroplasty. After primary thumb CMC surgery, reported pain values at rest range from 0.9 to 1.2 and 1.8 to 3.0 (during activities) (Marks et al, 2019;Wilcke et al, 2020), which are lower, and indicative of less pain compared with our respective scores of 1.6 and 2.7 after revision surgery. For hand function, brief MHQ scores of 62 to 83 (indicative of higher hand function) were reported after primary surgery (Efanov et al, 2019;Marks et al, 2019;Waljee et al, 2011) compared with the lower (worse) score of 63 in this revision series.…”

“…The results of this study showed that patients were satisfied with the outcome of their thumb CMC revision surgery, yet there were still some residual symptoms after revision. Although the need for revision after resection arthroplasty is rare in cases of thumb CMC OA, the outcome after further surgery is less favourable than that reported after primary thumb CMC replacement arthroplasty (Efanov et al, 2019;Marks et al, 2019;Waljee et al, 2011;Wilcke et al, 2020). Therefore, it is essential to inform the patients about the possibility of persisting symptoms if revision surgery is required.…”