Purpose
We hypothesized that repeat injections are associated with a decreased rate of success
and that the success rate of injections correlates with patient comorbidities.
Methods
Using a commercially available insurance database, patients diagnosed with De Quervain
tenosynovitis were identified using International Classification of Diseases, Ninth
Revision and Tenth Revision codes and stratified by therapeutic interventions, including
therapy, injections, and surgery, as well as comorbidities. Injection failure was
defined as a patient receiving a repeat injection or subsequent surgical management.
Success was defined as no further therapies identified after an intervention.
Results
From 2007 to 2017, 33,420 patients with a primary diagnosis of De Quervain tenosynovitis
were identified. Women represented 77.5% (25,908) of the total and were 2.6 times
more likely to be diagnosed than men. Black patients were more likely to be diagnosed
than White patients. Black and White women were found to have the highest incidence
(relative risk 3.4 and 2.3, respectively, compared with White men). Age was also significantly
correlated with an increased risk of diagnosis of the condition, with a peak incidence
at the age of 40–59 years (relative risk, 10.6). Diabetes, rheumatoid arthritis, lupus,
and hypothyroidism were associated with an increased risk of diagnosis. Overall, 53.3%
of the patients were treated with injections, 11.6% underwent surgery, and 5.2% underwent
therapy. Treatment with a single injection was successful in 71.9% of the patients,
with 19.7% receiving a repeat injection and 8.4% treated with surgery. The overall
success rate of subsequent injections was 66.3% for the second injection and 60.5%
for the third. The initial injection had a higher rate of success in diabetics than
in nondiabetics; however, the difference (2%) was not clinically relevant.
Conclusions
Although the success rate for the treatment of De Quervains tenosynovitis decreases
with multiple injections, repeat injections have a high rate of success and are a
viable clinical option.
Type of study/level of evidence
Therapeutic II.
Key words
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Article info
Publication history
Published online: June 16, 2021
Accepted:
April 12,
2021
Received:
June 10,
2019
Footnotes
No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.
Identification
Copyright
© 2022 by the American Society for Surgery of the Hand. All rights reserved.
