Routinely collected outcomes of proximal row carpectomy

JS Teunissen; LS Duraku; R Feitz; JM Zuidam; RW Selles; A Rooney; K Hamlin; Y Khan; Gulraj Matharu; AEF Haddon; SA Riesmeijer; BA van der Berge; JCE Lane; GM Smith; D Furniss; RM Wouters

doi:10.1016/j.jhsa.2022.09.004

Routinely collected outcomes of proximal row carpectomy

JS Teunissen^*
, LS Duraku
, R Feitz
, JM Zuidam
, RW Selles
, A Rooney
, K Hamlin
, Y Khan
, Gulraj Matharu
, AEF Haddon
, SA Riesmeijer
, BA van der Berge
, JCE Lane
, GM Smith
, D Furniss
, RM Wouters

^*Corresponding author for this work

Bristol Medical School (THS)

Research output: Contribution to journal › Article (Academic Journal) › peer-review

3 Citations (Scopus)

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Abstract

Purpose
To describe patient-reported pain and function 12 months after proximal row carpectomy (PRC). Secondary outcomes included return to work, grip strength, range of wrist motion, satisfaction with treatment results, and complications.
Methods
This cohort study was part of the British Society for Surgery of the Hand Studyathon 2021, using ongoing routinely-collected data of 304 eligible patients who underwent PRC (73% scapholunate advanced collapse, 11% scaphoid nonunion advanced collapse wrist; 11% Kienböck, 5% other indications) from Xpert Clinics, the Netherlands between 2012–2020. The primary outcome was the Patient Rated Wrist/Hand Evaluation total score (range, 0–100, lower scores indicate better performance).
Results
Of the 304 patients, the primary outcome was available in 217 patients. The total Patient Rated Wrist/Hand Evaluation score improved from 60 (95% confidence interval [CI], 57–63) to 38 (95% CI, 35–41) at 3 months, and 26 (95% CI, 23–29) at 12 months. The pain and function subscales improved by 18 (95% CI, 17–20) and 16 (95% CI, 14–18) points, respectively. At 12 months, 82% had returned to work at a median time of 12 (95% CI, 9–14) weeks following PRC. Grip strength did not improve. Wrist flexion and extension demonstrated a clinically irrelevant decrease. Satisfaction with treatment result was excellent in 27% of patients, good in 42%, fair in 20%, moderate in 6%, and poor in 5%. Complications occurred in 11% of patients, and conversion to wrist arthroplasty occurred in 2 patients.
Conclusion
A clinically relevant improvement in patient-reported pain and function was observed at 3 months after PRC, with continued improvement to 12 months. These data can be used for shared-decision making and expectation management.
Type of study/level of evidence
Therapeutic IV

Original language	English
Journal	The Journal of Hand Surgery
Early online date	11 Nov 2022
DOIs	https://doi.org/10.1016/j.jhsa.2022.09.004
Publication status	E-pub ahead of print - 11 Nov 2022

Bibliographical note

Funding Information:
We thank all patients who completed questionnaires as part of their clinical care and who agreed that their data could be used anonymously for the present study. In addition, we thank the members of the Hand-Wrist Study Group, caregivers, and personnel of Xpert Clinics, Xpert Handtherapie, and Equipe Zorgbedrijven for assisting in the routine outcome measurements that are the basis for this study.

Publisher Copyright:
© 2022 American Society for Surgery of the Hand

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PIIS0363502322005391
This is the final published version of the article (version of record). It first appeared online via Elsevier at https://doi.org/10.1016/j.jhsa.2022.09.004. Please refer to any applicable terms of use of the publisher
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Teunissen, JS., Duraku, LS., Feitz, R., Zuidam, JM., Selles, RW., Rooney, A., Hamlin, K., Khan, Y., Matharu, G., Haddon, AEF., Riesmeijer, SA., van der Berge, BA., Lane, JCE., Smith, GM., Furniss, D., & Wouters, RM. (2022). Routinely collected outcomes of proximal row carpectomy. The Journal of Hand Surgery. Advance online publication. https://doi.org/10.1016/j.jhsa.2022.09.004

@article{c44e43c8e17f42b49fd8d57c656c2e4b,

title = "Routinely collected outcomes of proximal row carpectomy",

abstract = "Purpose To describe patient-reported pain and function 12 months after proximal row carpectomy (PRC). Secondary outcomes included return to work, grip strength, range of wrist motion, satisfaction with treatment results, and complications. Methods This cohort study was part of the British Society for Surgery of the Hand Studyathon 2021, using ongoing routinely-collected data of 304 eligible patients who underwent PRC (73\% scapholunate advanced collapse, 11\% scaphoid nonunion advanced collapse wrist; 11\% Kienb{\"o}ck, 5\% other indications) from Xpert Clinics, the Netherlands between 2012–2020. The primary outcome was the Patient Rated Wrist/Hand Evaluation total score (range, 0–100, lower scores indicate better performance). Results Of the 304 patients, the primary outcome was available in 217 patients. The total Patient Rated Wrist/Hand Evaluation score improved from 60 (95\% confidence interval [CI], 57–63) to 38 (95\% CI, 35–41) at 3 months, and 26 (95\% CI, 23–29) at 12 months. The pain and function subscales improved by 18 (95\% CI, 17–20) and 16 (95\% CI, 14–18) points, respectively. At 12 months, 82\% had returned to work at a median time of 12 (95\% CI, 9–14) weeks following PRC. Grip strength did not improve. Wrist flexion and extension demonstrated a clinically irrelevant decrease. Satisfaction with treatment result was excellent in 27\% of patients, good in 42\%, fair in 20\%, moderate in 6\%, and poor in 5\%. Complications occurred in 11\% of patients, and conversion to wrist arthroplasty occurred in 2 patients. Conclusion A clinically relevant improvement in patient-reported pain and function was observed at 3 months after PRC, with continued improvement to 12 months. These data can be used for shared-decision making and expectation management. Type of study/level of evidence Therapeutic IV",

author = "JS Teunissen and LS Duraku and R Feitz and JM Zuidam and RW Selles and A Rooney and K Hamlin and Y Khan and Gulraj Matharu and AEF Haddon and SA Riesmeijer and \{van der Berge\}, BA and JCE Lane and GM Smith and D Furniss and RM Wouters",

note = "Funding Information: We thank all patients who completed questionnaires as part of their clinical care and who agreed that their data could be used anonymously for the present study. In addition, we thank the members of the Hand-Wrist Study Group, caregivers, and personnel of Xpert Clinics, Xpert Handtherapie, and Equipe Zorgbedrijven for assisting in the routine outcome measurements that are the basis for this study. Publisher Copyright: {\textcopyright} 2022 American Society for Surgery of the Hand",

year = "2022",

month = nov,

day = "11",

doi = "10.1016/j.jhsa.2022.09.004",

language = "English",

journal = "The Journal of Hand Surgery",

issn = "1532-2211",

publisher = "Churchill Livingstone",

}

TY - JOUR

T1 - Routinely collected outcomes of proximal row carpectomy

AU - Teunissen, JS

AU - Duraku, LS

AU - Feitz, R

AU - Zuidam, JM

AU - Selles, RW

AU - Rooney, A

AU - Hamlin, K

AU - Khan, Y

AU - Matharu, Gulraj

AU - Haddon, AEF

AU - Riesmeijer, SA

AU - van der Berge, BA

AU - Lane, JCE

AU - Smith, GM

AU - Furniss, D

AU - Wouters, RM

N1 - Funding Information: We thank all patients who completed questionnaires as part of their clinical care and who agreed that their data could be used anonymously for the present study. In addition, we thank the members of the Hand-Wrist Study Group, caregivers, and personnel of Xpert Clinics, Xpert Handtherapie, and Equipe Zorgbedrijven for assisting in the routine outcome measurements that are the basis for this study. Publisher Copyright: © 2022 American Society for Surgery of the Hand

PY - 2022/11/11

Y1 - 2022/11/11

N2 - Purpose To describe patient-reported pain and function 12 months after proximal row carpectomy (PRC). Secondary outcomes included return to work, grip strength, range of wrist motion, satisfaction with treatment results, and complications. Methods This cohort study was part of the British Society for Surgery of the Hand Studyathon 2021, using ongoing routinely-collected data of 304 eligible patients who underwent PRC (73% scapholunate advanced collapse, 11% scaphoid nonunion advanced collapse wrist; 11% Kienböck, 5% other indications) from Xpert Clinics, the Netherlands between 2012–2020. The primary outcome was the Patient Rated Wrist/Hand Evaluation total score (range, 0–100, lower scores indicate better performance). Results Of the 304 patients, the primary outcome was available in 217 patients. The total Patient Rated Wrist/Hand Evaluation score improved from 60 (95% confidence interval [CI], 57–63) to 38 (95% CI, 35–41) at 3 months, and 26 (95% CI, 23–29) at 12 months. The pain and function subscales improved by 18 (95% CI, 17–20) and 16 (95% CI, 14–18) points, respectively. At 12 months, 82% had returned to work at a median time of 12 (95% CI, 9–14) weeks following PRC. Grip strength did not improve. Wrist flexion and extension demonstrated a clinically irrelevant decrease. Satisfaction with treatment result was excellent in 27% of patients, good in 42%, fair in 20%, moderate in 6%, and poor in 5%. Complications occurred in 11% of patients, and conversion to wrist arthroplasty occurred in 2 patients. Conclusion A clinically relevant improvement in patient-reported pain and function was observed at 3 months after PRC, with continued improvement to 12 months. These data can be used for shared-decision making and expectation management. Type of study/level of evidence Therapeutic IV

AB - Purpose To describe patient-reported pain and function 12 months after proximal row carpectomy (PRC). Secondary outcomes included return to work, grip strength, range of wrist motion, satisfaction with treatment results, and complications. Methods This cohort study was part of the British Society for Surgery of the Hand Studyathon 2021, using ongoing routinely-collected data of 304 eligible patients who underwent PRC (73% scapholunate advanced collapse, 11% scaphoid nonunion advanced collapse wrist; 11% Kienböck, 5% other indications) from Xpert Clinics, the Netherlands between 2012–2020. The primary outcome was the Patient Rated Wrist/Hand Evaluation total score (range, 0–100, lower scores indicate better performance). Results Of the 304 patients, the primary outcome was available in 217 patients. The total Patient Rated Wrist/Hand Evaluation score improved from 60 (95% confidence interval [CI], 57–63) to 38 (95% CI, 35–41) at 3 months, and 26 (95% CI, 23–29) at 12 months. The pain and function subscales improved by 18 (95% CI, 17–20) and 16 (95% CI, 14–18) points, respectively. At 12 months, 82% had returned to work at a median time of 12 (95% CI, 9–14) weeks following PRC. Grip strength did not improve. Wrist flexion and extension demonstrated a clinically irrelevant decrease. Satisfaction with treatment result was excellent in 27% of patients, good in 42%, fair in 20%, moderate in 6%, and poor in 5%. Complications occurred in 11% of patients, and conversion to wrist arthroplasty occurred in 2 patients. Conclusion A clinically relevant improvement in patient-reported pain and function was observed at 3 months after PRC, with continued improvement to 12 months. These data can be used for shared-decision making and expectation management. Type of study/level of evidence Therapeutic IV

U2 - 10.1016/j.jhsa.2022.09.004

DO - 10.1016/j.jhsa.2022.09.004

M3 - Article (Academic Journal)

C2 - 36372595

SN - 1532-2211

SN - 1531-6564

JO - The Journal of Hand Surgery

JF - The Journal of Hand Surgery

ER -

Routinely collected outcomes of proximal row carpectomy

Abstract

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