Purpose
Implant survival, range of motion, and complications of proximal interphalangeal joint
arthroplasty have been reported often, but patient-reported outcomes are less frequently
described. This study evaluated patients' experiences during the first year after
proximal interphalangeal joint arthroplasty, measured with the Michigan Hand Outcomes
Questionnaire (MHQ). The primary focus was the reduction of patient-reported pain
after proximal interphalangeal joint implant placement and the percentage of patients
who considered this reduction clinically relevant, indicated by the minimal clinically
important difference (MCID).
Methods
Data were collected prospectively; 98 patients completed the MHQ before and at 3 and
12 months after surgery. Our primary outcome was the change in the pain score. An
increase of 24 points or more was considered a clinically important difference. Secondary
outcomes included changes in MHQ total and subscale scores and MCIDs, range of motion
(ROM), patient satisfaction with the outcome of the surgery, and complications.
Results
The pain score improved significantly, from 42 (95% confidence interval, 38–46) at
baseline to 65 (95% confidence interval, 60–69) at 12 months after surgery. The MCID
was reached by 50% (n = 49) of patients. The ROM did not improve, reoperations occurred
in 13% (n = 13) of patients, and swan neck deformities only occurred among surface
replacement implants.
Conclusions
Although most patients undergoing arthroplasty for osteoarthritis experienced significantly
less pain after surgery, the pain reduction was considered clinically relevant in
only 50% (n = 49) of patients. Patients with high MHQ pain scores before surgery are
at risk for postoperative pain reduction that will not be clinically relevant. Likewise,
the other subscales of the MHQ improved after surgery, but reached a clinically relevant
improvement in only 46% (n = 45) to 63% (n = 62) of patients. This knowledge can be
used during preoperative consultation to improve shared decision making.
Type of study/level of evidence
Prognostic IV.
Key words
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Article info
Publication history
Published online: May 26, 2022
Accepted:
March 16,
2022
Received:
December 30,
2020
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.
