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

J Wrist Surg

Department of Plastic, Reconstructive, and Hand Surgery, Erasmus MC, Rotterdam, The Netherlands.

Published: August 2024

 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.  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 -tests and chi-square tests were undertaken to test differences between outcomes and satisfaction in patients who did or did not reach the MCID.  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.  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.  II.  Therapeutic.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11254475PMC
http://dx.doi.org/10.1055/s-0043-1771010DOI Listing

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