The effects of partial wrist denervation in wrist osteoarthritis: patient-reported outcomes and objective function

Abstract

This prospective longitudinal study aimed to analyse the effect of partial wrist denervation on patient-reported outcomes, quality of life and objective function in symptomatic wrist osteoarthritis during the first year after surgery. Sixty consecutive patients underwent an anterior and posterior interosseous neurectomy during 2018-2020. Disabilities of the Arm, Shoulder and Hand, Patient-Rated Wrist Evaluation, EuroQol-5D-3L, pain at rest and on load, and objective function were assessed preoperatively and 3, 6 and 12 months postoperatively. Generalized estimating equations were used to analyse the effect on the outcome variables. Disabilities of the Arm, Shoulder and Hand, Patient-Rated Wrist Evaluation and pain scores improved significantly postoperatively with no decline over time, but no patient reported outcome measure reached the minimal clinically important difference. Quality of life, strength and range of motion did not improve. We found no complications. Seventeen patients needed further surgery during the study period. More studies are needed to evaluate whether denervation is truly effective or not.Level of evidence: II.

Keywords: Disabilities of the Arm; Patient-Rated Wrist Evaluation; Quality of life; Shoulder and Hand; Wrist denervation; arthritis; patient-reported outcomes.

Figure 1.

Illustration of the surgical approach for wrist denervation. Red line indicates the position of skin incision just proximal to the distal radioulnar joint (DRU).