Nayar Suresh K, Glasser Rebecca, Deune E Gene, Ingari John V, LaPorte Dawn M
Department of Orthopaedic Surgery, The Johns Hopkins University, Baltimore, USA.
Arch Bone Jt Surg. 2020 May;8(3):383-390. doi: 10.22038/abjs.2019.41772.2128.
Patient-Reported Outcomes Measurement Information System (PROMIS) scores can quantify symptoms and limitations after upper extremity surgery. Our objective was to determine how these scores compare amongst patients with trapeziometacarpal osteoarthritis treated either nonoperatively or operatively.
In this retrospective comparative study, we compared PROMIS scores (upper extremity function [UEF], pain interference, and depression) between 43 patients who underwent nonoperative treatment (nonsteroidal anti-inflammatory drugs/splinting/injections) and 33 patients who underwent trapeziectomy with ligament reconstruction and tendon interposition for trapeziometacarpal osteoarthritis (minimum 6-month recovery period) by 4 surgeons from 2014-2018. PROMIS scores were compared across all patients by Eaton-Littler staging. We used linear regression to assess correlations between time-since-surgery and each PROMIS domain. Multivariable linear regression was used to identify patient and disease factors independently associated with PROMIS scores.
Surgery was not associated with better UEF (37 vs. 40, ), less pain interference (58 vs. 56, ), or fewer symptoms of depression (47 vs. 46, ). Similarly, no differences were observed across all patient by Eaton-Littler stage for UEF (), pain (=0.48), or depression (). For the operative group, greater time-since-surgery, or patient recovery period, correlated moderately with worse UEF (R=0.41) and increased pain (R=0.37).
In small retrospective comparative cohorts, surgery was not associated with better UEF, pain, or depression scores compared with nonoperative treatment for trapeziometacarpal osteoarthritis.
患者报告结局测量信息系统(PROMIS)评分可量化上肢手术后的症状和功能受限情况。我们的目的是确定这些评分在接受非手术或手术治疗的大多角骨-掌骨关节骨关节炎患者之间的比较情况。
在这项回顾性比较研究中,我们比较了2014年至2018年期间43例接受非手术治疗(非甾体类抗炎药/夹板固定/注射)的患者与33例接受大多角骨切除术加韧带重建和肌腱植入治疗大多角骨-掌骨关节骨关节炎(至少6个月恢复期)的患者的PROMIS评分(上肢功能[UEF]、疼痛干扰和抑郁)。4位外科医生参与了研究。根据伊顿-利特勒分期对所有患者的PROMIS评分进行比较。我们使用线性回归来评估术后时间与每个PROMIS领域之间的相关性。多变量线性回归用于确定与PROMIS评分独立相关的患者和疾病因素。
手术与更好的上肢功能(37对40, )、更少的疼痛干扰(58对56, )或更少的抑郁症状(47对46, )无关。同样,根据伊顿-利特勒分期,在所有患者中,上肢功能( )、疼痛(=0.48)或抑郁( )方面均未观察到差异。对于手术组,术后时间更长或患者恢复期更长与更差的上肢功能(R=0.41)和疼痛增加(R=0.37)中度相关。
在小型回顾性比较队列中,与大多角骨-掌骨关节骨关节炎的非手术治疗相比,手术与更好的上肢功能、疼痛或抑郁评分无关。