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14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)

17.06. - 21.06.2019, Berlin

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Analysis of BSSH UK Hand Registry shows no difference in outcomes between simple trapeziumectomy and trapeziumectomy plus LRTI

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  • presenting/speaker Matthew Gardiner - Kennedy Institute of Rheumatology, NDORMS, University of Oxford, Oxford, United Kingdom
  • Jennifer Lane - Botnar Research Centre, NDORMS, University of Oxford, Oxford, United Kingdom
  • Jeremy Rodrigues - Botnar Research Centre, NDORMS, University of Oxford, Oxford, United Kingdom
  • Robert Poulter - Royal Cornwall Hospital, Truro, United Kingdom
  • Dominic Furniss - Botnar Research Centre, NDORMS, University of Oxford, Oxford, United Kingdom

International Federation of Societies for Surgery of the Hand. International Federation of Societies for Hand Therapy. 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT). Berlin, 17.-21.06.2019. Düsseldorf: German Medical Science GMS Publishing House; 2020. DocIFSSH19-918

doi: 10.3205/19ifssh0869, urn:nbn:de:0183-19ifssh08692

Published: February 6, 2020

© 2020 Gardiner et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Objectives/Interrogation: Surgery for thumb base osteoarthritis (TBOA) is common. It is one of the domains recorded by the UK Hand Registry (UKHR). The aim of this study was to analyse the TBOA registry data to assess the impact of surgical procedure type on patient reported outcome measures (PROMs) and EQ5D.

Methods: The UK Hand Registry (UKHR, formerly called the BSSH Audit Database) prospectively collects data from patients undergoing hand surgery as part of an approved national quality assurance process. This study involved secondary analysis of fully anonymised data from inception of the registry. Exemption from ethical approval was confirmed by University of Oxford Clinical Trials and Research Governance prospectively. Prospectively collected data from patients undergoing TBOA surgery were analysed from February 2012 to January 2018 inclusive. Outcomes were evaluated using EQ5D index and Patient Evaluation Measure part 2 (PEM) outcome measures at baseline, three, six and 12 months post-operatively. Regression analyses were conducted with procedure type, age and gender as factors.

Results and Conclusions: A total of 1456 TBOA procedures were added during the study period. Most were simple trapeziumectomy (51%) or trapeziumectomy plus ligament reconstruction and tendon interposition (LRTI) (45%). Other procedures were excluded from our analysis. There was no statistical difference between the demographics (age, gender) or baseline PROMs (EQ5D; Patient Evaluation Measure, PEM) for the two groups. The mean age was 65 years (SD 9); 78% of the population was female.

There was a significant improvement in EQ5D index and PEM for each postoperative time point up to 12 months for both groups. However, there was no significant difference between the two groups at any time point.

Regression analysis showed gender to be a significant contributing factor to outcome. Male patients had less improvement following surgery at each time point.

This study showed surgery for TBOA significantly improved patient outcomes. Our findings support previous studies suggesting no difference in outcomes between the two most common surgical procedures.