TY - JOUR
T1 - Prevalence of complications and association with patient-reported outcomes after trapeziectomy with a Weilby sling
T2 - A cohort study
AU - Hoogendam, Lisa
AU - van der Oest, Mark J.W.
AU - the Hand-Wrist Study Group
AU - Vermeulen, Guus M.
AU - Feitz, Reinier
AU - Hovius, Steven E.R.
AU - Zuidam, J. Michiel
AU - Slijper, Harm P.
AU - Selles, Ruud W.
AU - Wouters, Robbert M.
N1 - Funding Information:
The authors thank all patients who participated and allowed their data to be used anonymously for the present study.
Publisher Copyright:
© 2023
PY - 2023/5
Y1 - 2023/5
N2 - Purpose: The primary aim of this study was to report complications during the first year after trapeziectomy with Weilby sling using a standardized tool designed by the International Consortium for Health Outcome Measures. The secondary aim was to determine the association of complications and patient-reported outcomes 12 months after surgery. Methods: We included patients who underwent trapeziectomy with Weilby sling between November 2013 and December 2018. All complications during the first year were scored using the International Consortium for Health Outcomes Measurement Complications in Hand and Wrist conditions (ICHAW) tool. Pain and hand function were measured before surgery and 12 months after surgery using the Michigan Hand Outcomes Questionnaire (MHQ). Minimally Important Change thresholds of 18.6 for MHQ pain and 9.4 for MHQ function were used to determine clinical importance. Results: Of 531 patients after trapeziectomy with Weilby sling, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced Grade 2 or 3 deviations, including requiring antibiotics, corticosteroid injections, or additional surgery. On average, patients improved in pain and hand function, even in the presence of ICHAW events. Although all ICHAW grades were associated with poorer patient-reported outcomes 12 months after surgery, Grade 2 and 3 exceeded the Minimally Important Change threshold for pain and/or function. Conclusions: In 531 patients, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced grade 2 or 3 deviations. We recommend describing Grade 1 as “adverse protocol deviations” and grade 2 and 3 as complications, because of clinically relevant poorer patient-reported outcomes 12 months after surgery. The ICHAW is a promising tool to evaluate systematically and compare complications in hand surgery, although we recommend further evaluation. Type of study/level of evidence: Therapeutic IV.
AB - Purpose: The primary aim of this study was to report complications during the first year after trapeziectomy with Weilby sling using a standardized tool designed by the International Consortium for Health Outcome Measures. The secondary aim was to determine the association of complications and patient-reported outcomes 12 months after surgery. Methods: We included patients who underwent trapeziectomy with Weilby sling between November 2013 and December 2018. All complications during the first year were scored using the International Consortium for Health Outcomes Measurement Complications in Hand and Wrist conditions (ICHAW) tool. Pain and hand function were measured before surgery and 12 months after surgery using the Michigan Hand Outcomes Questionnaire (MHQ). Minimally Important Change thresholds of 18.6 for MHQ pain and 9.4 for MHQ function were used to determine clinical importance. Results: Of 531 patients after trapeziectomy with Weilby sling, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced Grade 2 or 3 deviations, including requiring antibiotics, corticosteroid injections, or additional surgery. On average, patients improved in pain and hand function, even in the presence of ICHAW events. Although all ICHAW grades were associated with poorer patient-reported outcomes 12 months after surgery, Grade 2 and 3 exceeded the Minimally Important Change threshold for pain and/or function. Conclusions: In 531 patients, 65% had an uneventful recovery, 16% experienced ICHAW Grade 1 deviations only, and 19% experienced grade 2 or 3 deviations. We recommend describing Grade 1 as “adverse protocol deviations” and grade 2 and 3 as complications, because of clinically relevant poorer patient-reported outcomes 12 months after surgery. The ICHAW is a promising tool to evaluate systematically and compare complications in hand surgery, although we recommend further evaluation. Type of study/level of evidence: Therapeutic IV.
UR - http://www.scopus.com/inward/record.url?scp=85150275255&partnerID=8YFLogxK
U2 - 10.1016/j.jhsa.2023.01.022
DO - 10.1016/j.jhsa.2023.01.022
M3 - Article
C2 - 36932010
AN - SCOPUS:85150275255
SN - 0363-5023
VL - 48
SP - 469
EP - 478
JO - Journal of Hand Surgery
JF - Journal of Hand Surgery
IS - 5
ER -