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. 2023 Jul 7;13(4):302-309.
doi: 10.1055/s-0043-1771010. eCollection 2024 Aug.

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

Reinier Feitz  1 , Yara E van Kooij  1   2   3 , Mark J W van der Oest  1   4 , J Sebastiaan Souer  4 , Steven E R Hovius  4   5 , Ruud W Selles  1   2 ; Hand–Wrist Study Group
Affiliations

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

Reinier Feitz et al. J Wrist Surg. .

Abstract

Purpose 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. Methods 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 t -tests and chi-square tests were undertaken to test differences between outcomes and satisfaction in patients who did or did not reach the MCID. Results 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. Conclusion 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. Level of Evidence II. Type of Study Therapeutic.

Keywords: PROM; TFCC; open reinsertion; outcome; prognostic factors; surgery; triangular fibrocartilage.

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Conflict of interest statement

Conflict of Interest None declared.

Figures

Fig. 1
Fig. 1
Flowchart. PRWE, patient-rated wrist evaluation; TFCC, triangular fibrocartilage complex.
Fig. 2
Fig. 2
Patient-rated wrist evaluation (PRWE). MCID, minimal clinically important difference.
Fig. 3
Fig. 3
Patient-rated experience measure (PREM).
Fig. 4
Fig. 4
Satisfaction. MCID, minimal clinically important difference.
See this image and copyright information in PMC

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