Patient- and Disease-Specific Factors Associated With Operative Management of de Quervain Tendinopathy

Kazmers, Nikolas H.; Liu, Tiffany C.; Gordon, Joshua A.; Bozentka, David J.; Steinberg, David R.; Gray, Benjamin L.

doi:10.1016/j.jhsa.2017.07.017

Cited by 12 publications

(6 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A randomized control trial of 83 patients with de Quervain’s had study population that was 85% female with a mean age of 50 years [17]. Another study of 200 patients with de Quervain’s had a population that was 86% female with a mean age of 50 years [12]. Therefore, it is likely that the included patients are representative of people with de Quervain’s tenosynovitis and the results of this study are applicable to most.…”

Section: Discussionmentioning

confidence: 99%

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

Blackburn¹,

Oest²,

Chen³

et al. 2020

Clin Orthop Relat Res

View full text Add to dashboard Cite

Background Psychological factors such as depression, pain catastrophizing, kinesiophobia, pain anxiety, and more negative illness perceptions are associated with worse pain and function in patients at the start of treatment for de Quervain’s tenosynovitis. Longitudinal studies have found symptoms of depression and pain catastrophizing at baseline were associated with worse pain after treatment. It is important to study patients opting for surgery for their condition because patients should choose surgical treatment based on their values rather than misconceptions. Psychological factors associated with worse patient-reported outcomes from surgery for de Quervain’s tenosynovitis should be identified and addressed preoperatively so surgeons can correct any misunderstandings about the condition. Question/purpose What preoperative psychosocial factors (depression, anxiety, pain catastrophizing, illness perception, and patient expectations) are associated with pain and function 3 months after surgical treatment of de Quervain’s tenosynovitis after controlling for demographic characteristics? Methods This was a prospective cohort study of 164 patients who underwent surgery for de Quervain’s tenosynovitis between September 2017 and October 2018 performed by 20 hand surgeons at 18 centers. Our database included 326 patients who underwent surgery for de Quervain’s tenosynovitis during the study period. Of these, 62% (201 of 326) completed all baseline questionnaires and 50% (164 of 326) also completed patient-reported outcomes at 3 months postoperatively. We found no difference between those included and those not analyzed in terms of age, sex, duration of symptoms, smoking status, and workload. The mean ± SD age of the patients was 52 ± 14 years, 86% (141 of 164) were women, and the mean duration of symptoms was 13 ± 19 months. Patients completed the Patient-Rated Wrist Evaluation (PRWE), the VAS for pain and function, the Patient Health Questionnaire for symptoms of anxiety and depression, the Pain Catastrophizing Scale, the Credibility/Expectations Questionnaire, and the Brief Illness Perceptions questionnaire at baseline. Patients also completed the PRWE and VAS for pain and function at 3 months postoperatively. We used a hierarchical multivariable linear regression model to investigate the relative contribution of patient demographics and psychosocial factors to the pain and functional outcome at 3 months postoperatively. Results After adjusting for demographic characteristics, psychosocial factors, and baseline PRWE score, we found that only the patient’s expectations of treatment and how long their illness would last were associated with the total PRWE score at 3 months postoperatively. More positive patient expectations of treatment were associated with better patient-reported pain and function at 3 months postoperatively (ß = -2.0; p < 0.01), while more negative patient perceptions of how long their condition would last were associated with worse patient-reported pain and function (timeline ß = 2.7; p < 0.01). The final model accounted for 31% of the variance in the patient-reported outcome at 3 months postoperatively. Conclusion Patient expectations and illness perceptions are associated with patient-reported pain and functional outcomes after surgical decompression for de Quervain’s tenosynovitis. Addressing misconceptions about de Quervain’s tenosynovitis in terms of the consequences for patients and how long their symptoms will last should allow patients to make informed decisions about the treatment that best matches their values. Prospective studies are needed to investigate whether addressing patient expectations and illness perceptions, with decision aids for example, can improve patient-reported pain and function postoperatively in those patients who still choose surgery for de Quervain’s tenosynovitis. Level of Evidence Level III, therapeutic study.

show abstract

Section: Discussionmentioning

confidence: 99%

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

Blackburn¹,

Oest²,

Chen³

et al. 2020

Clin Orthop Relat Res

View full text Add to dashboard Cite

show abstract

“…Some factors may decrease the efficacy of conservative treatment. Patients with a lower psychosocial well-being response were reported to perceive higher levels of dissatisfaction from conservative treatment [8]. Ilyas [7] stated that splinting is an essential part of successful conservative management, and decreased cooperation of the patient to splinting may decrease the success.…”

Section: Discussionmentioning

confidence: 99%

“…Most surgeons recommend conservative management including splinting and nonsteroidal anti-inflammatory drugs as the first line treatment [7]. In case of failure of conservative treatment, a single dose of local corticosteroid administration may be helpful for relieving the pain up to 83% of the cases [8]. Additional conservative management modalities include acupuncture, platelet-rich plasma injection, hyaluranic acid injection, and ultrasound [9,10].…”

Section: Introductionmentioning

confidence: 99%

De Quervain olgularında konservatif tedavi başarısını etkileyen faktörler

Ceylan

Kaya

Çaypınar

et al. 2018

Archives of Clinical and Experimental Medicine

View full text Add to dashboard Cite

Aim: De Quervain's disease, which is known as tenosynovitis of the first radial dorsal compartment, usually is a self-limiting condition and it could be managed conservatively. In this study, we aimed to evaluate the factors affecting the success of the conservative treatment. Methods: Patients who admitted to outpatient service with radial styloid pain and diagnosed as de Quervain's disease between March 2014 and December 2016 were enrolled to our study. A total number of 84 patients evaluated retrospectively, and 12 of them excluded due to inadequate patient information, previous interventions in other clinics, and lost to follow up. Patients' files with regard to the patients' data on age, sex, duration of symptomatic period, history of previous trauma, season of admission and need of surgery were evaluated. Results: Mean age of the patients was 42.24 (range 16-66) years. Of the cohort, 58 patients (80.6%) were female and the remaining patients (19.4%) were male. Mean length of pre-admission symptomatic period was 2.2 (range 1-12) months. There was no significant correlation between the resistance to treatment and the duration of the symptoms (r=0.4597). Sixty-one of 72 patients (84.7%) received one month of orthosis and oral/local medication and they were all healed. The remaining 11 patients with persistent pain received additional steroid injections. The mean age was 46.72 years at the injection group, and 10 of these 11 were female. Two female patients from these 11 resistant cases underwent surgical decompression. Conclusion: In conclusion, our study also supported the self-limiting clinical feature of de Quervain's disease. Most of the patients have satisfactory results with conservative treatment or corticosteroid injections if needed. Most of the patients who needed corticosteroid injections in addition to splint use were female; therefore, the female patients should be informed in this aspect.

show abstract

“…Kazmers et al [35] showed that certain psychosocial factors were associated with a higher rate of surgical treatment. In our study, 'being on sick leave' was identified as a predictor of poor outcomes, as it was associated with more frequent surgical treatment (OR = 14).…”

Section: Comparison With Other Studies and Techniquesmentioning

confidence: 99%

US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases

et al. 2018

View full text Add to dashboard Cite

show abstract

Patient- and Disease-Specific Factors Associated With Operative Management of de Quervain Tendinopathy

Cited by 12 publications

References 35 publications

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

Are Patient Expectations and Illness Perception Associated with Patient-reported Outcomes from Surgical Decompression in de Quervain’s Tenosynovitis?

De Quervain olgularında konservatif tedavi başarısını etkileyen faktörler

US-guided percutaneous release of the first extensor tendon compartment using a 21-gauge needle in de Quervain’s disease: a prospective study of 35 cases

Contact Info

Product

Resources

About