PDF herunterladen
CC BY 4.0 · J Wrist Surg 2024; 13(04): 302-309
DOI: 10.1055/s-0043-1771010
Scientific Article

Patient-Rated Wrist Evaluation Threshold for Successful Open Surgery of the Triangular Fibrocartilage Complex

Reinier Feitz 
1   Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands
,
Yara E. van Kooij 
1   Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands
4   Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
5   Xpert Clinics, Xpert Handtherapie, Flight Forum, Eindhoven, The Netherlands
,
Mark J. W. van der Oest 
1   Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands
2   Hand and Wrist Center, Xpert Clinics, Amsterdam, The Netherlands
,
J Sebastiaan Souer 
2   Hand and Wrist Center, Xpert Clinics, Amsterdam, The Netherlands
,
Steven E. R. Hovius 
2   Hand and Wrist Center, Xpert Clinics, Amsterdam, The Netherlands
3   Department of Plastic, Reconstructive and Hand Surgery, Radboud University Medical Center, Radboud Institute for Health Sciences, Nijmegen, The Netherlands
,
Ruud W. Selles 
1   Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands
4   Department of Rehabilitation Medicine, Erasmus MC, Rotterdam, The Netherlands
,
the Hand–Wrist Study Group › Institutsangaben Funding No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this study.
› Weitere Informationen
   Lizenzen und Reprints

Abstract

Purpose To determine thresholds in patient-reported outcome measures at baseline in patients electing to undergo triangular fibrocartilage complex (TFCC) surgery to select patients with clinically improved outcomes.

Methods The study cohort comprised consecutive patients who underwent open TFCC repair between December 2011 and December 2018 in various clinics in the Netherlands. All patients were asked to complete the patient-rated wrist evaluation (PRWE) questionnaire at baseline as well as at 12 months postoperatively. The minimal clinically important difference (MCID) for the PRWE was calculated to be 24 using an anchor-based method. We compared patient, disease, and surgical characteristics between patients who did and did not reach the MCID. The t-tests and chi-square tests were undertaken to test differences between outcomes and satisfaction in patients who did or did not reach the MCID.

Results Patients (34%) who did not reach MCID had a longer history of complaints. The chances of reaching the MCID for patients with a low PRWE score at baseline were slim. Of patients with a PRWE score <34 at baseline, only 14% reached the MCID, whereas in patients with a PRWE score of ≥34, 69% reached the MCID.

Conclusion A PRWE total score at baseline <34 is a strong signal to reconsider open surgery of the TFCC because the chance of reaching a clinically meaningful outcome is slim.

Level of Evidence II.

Type of Study Therapeutic.

Keywords

TFCC - triangular fibrocartilage - PROM - surgery - open reinsertion - outcome - prognostic factors

Type of Study

LEVEL II, prognostic study, high-quality prospective study <80% follow-up, consecutive patients.


Ethical Approval of the Study Protocol

The ethics committee of the Erasmus University Medical Center approved our study protocol (NL/sl/MEC-2018-1088). All patients provided consent for their data to be used in this study.


Authors' Contribution

R.F., Y.E.v.K. and M.J.W.O. did the analyses. R.F., J.S.S., and S.E.R.H. treated several patients. All authors contributed to the design of the study, discussed the results, commented on the manuscript, and reviewed the final version. Each of the HWS group collaborators contributed by treating patients from the cohort or engaging in defining, enabling, or managing the data collection/analyses.


* See Appendix A (available in the online version).


Supplementary Material



Publikationsverlauf

Eingereicht: 06. Februar 2023

Angenommen: 07. Juni 2023

Artikel online veröffentlicht:
07. Juli 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical Publishers, Inc.
333 Seventh Avenue, 18th Floor, New York, NY 10001, USA

 

  • References

  • 1 Andersson JK, Åhlén M, Andernord D. Open versus arthroscopic repair of the triangular fibrocartilage complex: a systematic review. J Exp Orthop 2018; 5 (01) 6
    CrossrefPubMedGoogle Scholar
  • 2 Luchetti R, Atzei A, Cozzolino R, Fairplay T, Badur N. Comparison between open and arthroscopic-assisted foveal triangular fibrocartilage complex repair for post-traumatic distal radio-ulnar joint instability. J Hand Surg Eur Vol 2014; 39 (08) 845-855
    CrossrefPubMedGoogle Scholar
  • 3 Feitz R, Teunissen JS, van der Oest MJW, van der Heijden EPA, Selles RW, Hovius SER. Hand–Wrist Study Group. Factors associated with return to work after open reinsertion of the triangular fibrocartilage. Hand Surg Rehabil 2021; 40 (04) 405-412
    CrossrefPubMedGoogle Scholar
  • 4 Feitz R, van der Oest MJW, van der Heijden EPA, Slijper HP, Selles RW, Hovius SER. Hand-Wrist Study Group. Patient-reported outcomes and function after reinsertion of the triangular fibrocartilage complex by open surgery. Bone Joint J 2021; 103-B (04) 711-717
    CrossrefPubMedGoogle Scholar
  • 5 Blackburn J, van der Oest MJW, Selles RW. et al. Which psychological variables are associated with pain and function before surgery for de Quervain's tenosynovitis? A cross-sectional study. Clin Orthop Relat Res 2019; 477 (12) 2750-2758
    CrossrefPubMedGoogle Scholar
  • 6 Tsehaie J, van der Oest MJW, Poelstra R. et al; Hand-Wrist Study Group. Positive experience with treatment is associated with better surgical outcome in trapeziometacarpal osteoarthritis. J Hand Surg Eur Vol 2019; 44 (07) 714-721
    CrossrefPubMedGoogle Scholar
  • 7 van der Oest MJW, Poelstra R, Feitz R. et al; Hand-Wrist Study Group. Illness perceptions of patients with first carpometacarpal osteoarthritis, carpal tunnel syndrome, Dupuytren contracture, or trigger finger. J Hand Surg Am 2020; 45 (05) 455.e1-455.e8
    CrossrefPubMedGoogle Scholar
  • 8 Selles RW, Wouters RM, Poelstra R. et al; Hand-Wrist Study Group. Routine health outcome measurement: development, design, and implementation of the hand and wrist cohort. Plast Reconstr Surg 2020; 146 (02) 343-354
    CrossrefPubMedGoogle Scholar
  • 9 Feitz R, van Kooij YE, Ter Stege MHP. et al; Hand–Wrist Study Group. Closing the loop: a 10-year experience with routine outcome measurements to improve treatment in hand surgery. EFORT Open Rev 2021; 6 (06) 439-450
    CrossrefPubMedGoogle Scholar
  • 10 Garcia-Elias M, Smith DE, Llusá M. Surgical approach to the triangular fibrocartilage complex. Tech Hand Up Extrem Surg 2003; 7 (04) 134-140
    CrossrefPubMedGoogle Scholar
  • 11 Jung H-S, Park MJ, Won Y-S, Lee GY, Kim S, Lee JS. The correlation between shape of the sigmoid notch of the distal radius and the risk of triangular fibrocartilage complex foveal tear. Bone Joint J 2020; 102-B (06) 749-754
    CrossrefPubMedGoogle Scholar
  • 12 Videler AJ, Schreuders TAR. De Nederlandse versie van de Patient Rated Wrist/Hand Evaluation: de PRWHE-DLV. Accessed October 6, 2021, at: https://meetinstrumentenzorg.nl/instrumenten/patient-rated-wrist-hand-evaluation-patient-rated-wrist-evaluation/
    PubMed
  • 13 MacDermid JC, Turgeon T, Richards RS, Beadle M, Roth JH. Patient rating of wrist pain and disability: a reliable and valid measurement tool. J Orthop Trauma 1998; 12 (08) 577-586
    CrossrefPubMedGoogle Scholar
  • 14 Sorensen AA, Howard D, Tan WH, Ketchersid J, Calfee RP. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am 2013; 38 (04) 641-649
    CrossrefPubMedGoogle Scholar
  • 15 Terluin B, Eekhout I, Terwee CB, de Vet HC. Minimal important change (MIC) based on a predictive modeling approach was more precise than MIC based on ROC analysis. J Clin Epidemiol 2015; 68 (12) 1388-1396
    CrossrefPubMedGoogle Scholar
  • 16 Terluin B, Eekhout I, Terwee CB. The anchor-based minimal important change, based on receiver operating characteristic analysis or predictive modeling, may need to be adjusted for the proportion of improved patients. J Clin Epidemiol 2017; 83: 90-100
    CrossrefPubMedGoogle Scholar
  • 17 Hosmer Jr DW, Lemeshow S, Sturdivant RX. Applied Logistic Regression. Vol. 398. John Wiley & Sons: Hoboken, New Jersey, USA; 2013
    CrossrefGoogle Scholar
  • 18 Hoogendam L, Koopman JE, van Kooij YE. et al; Hand-Wrist Study Group. What are the minimally important changes of four commonly used patient-reported outcome measures for 36 hand and wrist condition-treatment combinations?. Clin Orthop Relat Res 2022; 480 (06) 1152-1166
    CrossrefPubMedGoogle Scholar
  • 19 Poelstra R, Selles RW, Slijper HP. et al; Hand-Wrist Study Group. Better patients' treatment experiences are associated with better postoperative results in Dupuytren's disease. J Hand Surg Eur Vol 2018; 43 (08) 848-854
    CrossrefPubMedGoogle Scholar
  • 20 Yeo MGH, Goh GS, Chen JY, Lo NN, Yeo SJ, Liow MHL. Are Oxford hip score and Western Ontario and McMaster Universities Osteoarthritis Index useful predictors of clinical meaningful improvement and satisfaction after total hip arthroplasty?. J Arthroplasty 2020; 35 (09) 2458-2464
    CrossrefPubMedGoogle Scholar
  • 21 Berliner JL, Brodke DJ, Chan V, SooHoo NF, Bozic KJ. Can preoperative patient-reported outcome measures be used to predict meaningful improvement in function after TKA?. Clin Orthop Relat Res 2017; 475 (01) 149-157
    CrossrefPubMedGoogle Scholar
  • 22 Robba V, Fowler A, Karantana A, Grindlay D, Lindau T. Open versus arthroscopic repair of 1B ulnar-sided triangular fibrocartilage complex tears: a systematic review. Hand (N Y) 2020; 15 (04) 456-464
    CrossrefPubMedGoogle Scholar
  • 23 Robba VI, Karantana A, Fowler APG, Diver C. Perceptions and experiences of wrist surgeons on the management of triangular fibrocartilage complex tears: a qualitative study. J Hand Surg Eur Vol 2019; 44 (06) 572-581
    CrossrefPubMedGoogle Scholar
  • 24 Stratford P, Gill C, Westaway M, Binkley J. Assessing disability and change on individual patients: a report of a patient specific measure. Physiother Can 1995; 47 (04) 258-263
    CrossrefPubMedGoogle Scholar
  • 25 Tubach F, Ravaud P, Baron G. et al. Evaluation of clinically relevant changes in patient reported outcomes in knee and hip osteoarthritis: the minimal clinically important improvement. Ann Rheum Dis 2005; 64 (01) 29-33
    CrossrefPubMedGoogle Scholar
  • 26 Tubach F, Ravaud P, Martin-Mola E. et al. Minimum clinically important improvement and patient acceptable symptom state in pain and function in rheumatoid arthritis, ankylosing spondylitis, chronic back pain, hand osteoarthritis, and hip and knee osteoarthritis: results from a prospective multinational study. Arthritis Care Res (Hoboken) 2012; 64 (11) 1699-1707
    CrossrefPubMedGoogle Scholar
  • 27 Marks M, Hensler S, Wehrli M, Schindele S, Herren DB. Minimal important change and patient acceptable symptom state for patients after proximal interphalangeal joint arthroplasty. J Hand Surg Eur Vol 2019; 44 (02) 175-180
    CrossrefPubMedGoogle Scholar
  • 28 Wilson CD, Mand D, Ring D, Ramtin S. A systematic review of satisfaction measures in hand and wrist surgery. J Hand Surg Am 2023; 48 (01) 1-8
    CrossrefPubMedGoogle Scholar