Meulendijks Mara Z, Lans Jonathan, Jupiter Jesse B, Chen Neal C
Department of Orthopaedic Surgery, Hand and Upper Extremity Service, General Hospital, Harvard Medical School, Boston, Massachusetts.
J Wrist Surg. 2024 Jun 4;13(5):398-405. doi: 10.1055/s-0044-1787178. eCollection 2024 Oct.
Proximal row carpectomy (PRC) is a procedure used for pain relief from arthrosis that preserves some degree of range of motion (ROM). Dorsal capsular interposition (DCI) is an option for cases where some chondral loss of the capitate is present. The aim of this study is to assess what factors influence long-term patient-reported outcomes following PRC and specifically to evaluate the role of DCI. Additionally, this study aims to report the long-term postoperative ROM in patients with DCI. Patients who underwent PRC in the period between 2002 and 2017 were retrospectively identified, resulting in a cohort of 162 patients. Patient-reported outcomes were obtained using validated questionnaires and were completed by 59 patients at a median follow-up time of 8.5 years (interquartile range [IQR]: 6.0-13). Multivariable linear regression was performed to identify factors independently associated with patient-reported outcomes. The median PRWE (Patient-Rated Wrist Evaluation) score was 17 (IQR: 5.5-52), the median QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand) score was 16 (IQR: 4.5-39), and the median NRS (Numeric Rating Scale) Pain score was 1 (IQR: 0-3). The mean flexion-extension ROM was 70 ± 24 degrees. After correcting for gender, involvement of the capitate cartilage was independently associated with worse QuickDASH scores. PRC is associated with good functional outcomes and pain control at long-term follow-up. This generally also applied to patients who underwent DCI; however, the role of DCI in those with capitate cartilage injury remains unclear. Preexistent damage to the capitate cartilage was associated with worse QuickDASH scores. II, Prognostic study.
近端腕骨切除术(PRC)是一种用于缓解关节病疼痛的手术,可保留一定程度的活动范围(ROM)。背侧关节囊置入术(DCI)适用于存在头状骨软骨部分缺失的病例。 本研究的目的是评估哪些因素会影响PRC术后患者报告的长期疗效,特别是评估DCI的作用。此外,本研究旨在报告接受DCI患者的术后长期ROM情况。 对2002年至2017年期间接受PRC的患者进行回顾性识别,共纳入162例患者。使用经过验证的问卷获取患者报告的疗效数据,59例患者完成了问卷,中位随访时间为8.5年(四分位间距[IQR]:6.0 - 13)。进行多变量线性回归以确定与患者报告疗效独立相关的因素。 PRWE(患者评定的腕关节评估)评分中位数为17(IQR:5.5 - 52),QuickDASH(手臂、肩部和手部快速残疾评估)评分中位数为16(IQR:4.5 - 39),NRS(数字评定量表)疼痛评分中位数为1(IQR:0 - 3)。屈伸ROM平均为70±24度。校正性别后,头状骨软骨受累与更差的QuickDASH评分独立相关。 PRC在长期随访中与良好的功能结局和疼痛控制相关。这通常也适用于接受DCI的患者;然而,DCI在头状骨软骨损伤患者中的作用仍不清楚。头状骨软骨的既往损伤与更差的QuickDASH评分相关。 二、预后研究。