Purpose
If early active motion after 3-ligament tenodesis is safe, it may yield more patient
comfort and an early return to activities. Therefore, the aim of this study was to
investigate whether early active motion is noninferior to late active motion after
3-ligament tenodesis for scapholunate interosseous ligament injuries.
Methods
This prospective, multicenter cohort study, using a noninferiority design with propensity
score matching, compared a late active motion protocol (immobilization for 10–16 days,
wrist therapy in weeks 5–6) with an early active motion protocol (immobilization for
3–5 days, wrist therapy during week 2). Patients who were older than 18 years, had
complete baseline information on demographics, and underwent 3-ligament tenodesis
were included. The outcome measures were postoperative Patient-Reported Wrist/Hand
Evaluation scores, pain, complications, return to work, range of motion, grip strength,
and satisfaction with treatment results at 3 months of follow-up.
Results
After propensity matching, a total of 108 patients were included. Patient-Reported
Wrist/Hand Evaluation and pain scores during physical load following an early active
motion protocol were noninferior compared with scores following a late active motion
protocol. Furthermore, early active motion did not lead to an increase of complications,
differences in range of motion or grip strength, or less satisfaction with the treatment
result. An earlier return to work was not observed.
Conclusions
Early active motion leads to noninferior results without more complications as compared
with late active motion. Based on these findings, early active motion can be considered
safe, and might be recommended due to its potential benefits compared with late active
motion after 3-ligament tenodesis.
Type of study/level of evidence
Therapeutic III.
Key words
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Article info
Publication history
Published online: August 30, 2022
Accepted:
July 6,
2022
Received:
November 26,
2021
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.
