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. 2025 Jun 4;7(4):100763.
doi: 10.1016/j.jhsg.2025.100763. eCollection 2025 Jul.

Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery

Brandon Leon  1 , Samir Kaveeshwar  1 , Yanni Kevas  1 , Daniel Rivkin  1 , Matheus B Schneider  1 , Leah E Henry  1 , Evan L Honig  1 , Michael A McCurdy  1 , Raymond A Pensy  1 , Christopher G Langhammer  1 , Ralph Frank Henn 3rd  1
Affiliations

Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery

Brandon Leon et al. J Hand Surg Glob Online. .

Abstract

Purpose: The purpose of this paper was to use validated instruments to identify if there is a relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing hand and wrist surgery. We hypothesized that preoperative expectations would be predictive of 2-year PROs in hand and wrist surgery patients.

Methods: In total, 253 patients who underwent hand and wrist surgery were enrolled in a prospective orthopedic registry. The Musculoskeletal Outcomes Data Evaluation and Management System was used to measure preoperative expectations. At both baseline and 2 years after surgery, patients completed multiple questionnaires with multiple PROs, including six domains of the PROs measurement information system (PROMIS) and the Brief Michigan Hand Questionnaire.

Results: Overall, patients undergoing hand and wrist surgery had high expectations. Worse preoperative expectations were significantly associated with smoking, worker's compensation or other legal claim, a greater number of prior surgeries, and worse baseline PROMIS physical function, fatigue, and anxiety (P < .05). Bivariate analysis indicated that greater preoperative expectations were associated with better 2-year PROMIS physical function, PROMIS pain interference, PROMIS fatigue, PROMIS depression, numeric pain scale, surgical satisfaction questionnaire scores, met expectations, and the Brief Michigan Hand Questionnaire (P < .05). Multivariable analysis controlling for confounding variables revealed that preoperative expectations were not independently predictive of any 2-year PROs.

Conclusions: Patients' preoperative expectations are associated with, but not independently predictive of, 2-year patient-reported outcomes.

Type/of study/level of evidence: Prognostic IIB.

Keywords: Hand surgery; PROMIS; Patient expectations; Patient-reported outcomes.

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Conflict of interest statement

No benefits in any form have been received or will be received related directly to this article.

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