Wu Shiny Chih-Hsuan, Hsu Chen-Heng, Chuang Chieh-An, Huan Sheu, Cheng You-Hung, Yang Cheng-Pang, Chiu Joe Chih-Hao, Cheng Chun-Ying, Chan Yi-Shen, Chen Alvin Chao-Yu
From the Department of Orthopedic Surgery, Bone and Joint Research Center, Chang Gung Memorial Hospital-Linkou and University College of Medicine, Taoyuan, Taiwan.
Comprehensive Sports Medicine Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Plast Reconstr Surg Glob Open. 2025 Apr 10;13(4):e6630. doi: 10.1097/GOX.0000000000006630. eCollection 2025 Apr.
Patient-based evaluations effectively quantify a patient's perception of the impact of a disorder and surgical results. With multiple surgical techniques for thumb carpometacarpal (CMC) arthritis, we propose a hybrid technique combining trapeziectomy with ligament reconstruction and tendon interposition and suture button suspensionplasty to evaluate its statistical significance and clinical relevance.
We conducted a retrospective study on patients receiving primary surgery of combining trapeziectomy with ligament reconstruction and tendon interposition and suture button suspensionoplasty for advanced osteoarthritis from 2017 to 2023. Patient-reported outcome measurements (PROMs) including Quick Disabilities of the Arm, Shoulder and Hand, pain visual analog scale (VAS), and single assessment numeric evaluation (SANE) were analyzed at 2 years. Receiver operating characteristic curves derived clinically significant outcome (CSO) thresholds of minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS).
PROMs from 32 hands (31 patients) exhibited significant difference at 2 years postoperatively. CSO thresholds of MCID were 18.2, 1, and 70 for Quick Disabilities of the Arm, Shoulder and Hand, VAS, and SANE, respectively. SCB values were 15.9, 1, and 75, and PASS were 18.2, 0, and 80. More than 80% of patients achieved CSO thresholds in all 3 scores, except for PASS in VAS and SANE scores, with 70% and 72% of patients reaching these cutoff values.
Significant improved difference were observed in 2-year PROMs, with most patients achieving MCID and SCB but not PASS for VAS and SANE scores. Continued observation of patients' perspectives on this surgery is warranted.
基于患者的评估有效地量化了患者对疾病影响和手术结果的认知。对于拇指腕掌关节（CMC）关节炎有多种手术技术，我们提出一种将大多角骨切除术与韧带重建、肌腱植入和缝线纽扣悬吊成形术相结合的混合技术，以评估其统计学意义和临床相关性。
我们对2017年至2023年接受大多角骨切除术与韧带重建、肌腱植入和缝线纽扣悬吊成形术联合一期手术治疗晚期骨关节炎的患者进行了一项回顾性研究。在术后2年分析患者报告的结局指标（PROMs），包括手臂、肩部和手部快速残疾评估、疼痛视觉模拟量表（VAS）和单项评估数字评价（SANE）。通过受试者操作特征曲线得出最小临床重要差异（MCID）、显著临床获益（SCB）和患者可接受症状状态（PASS）的临床显著结局（CSO）阈值。
32只手（31例患者）的PROMs在术后2年显示出显著差异。手臂、肩部和手部快速残疾评估、VAS和SANE的MCID的CSO阈值分别为18.2、1和70。SCB值分别为15.9、1和75，PASS分别为18.2、0和80。除VAS和SANE评分的PASS外，超过80%的患者在所有3项评分中达到CSO阈值，分别有70%和72%的患者达到这些临界值。
在2年的PROMs中观察到显著改善差异，大多数患者达到MCID和SCB，但VAS和SANE评分未达到PASS。有必要持续观察患者对该手术的看法。
