Scientific articleEvaluation of Expectations and Expectation Fulfillment in Patients Treated for Trapeziometacarpal Osteoarthritis
Section snippets
Materials and Methods
Between September 2011 and November 2012, 163 patients with radiographically confirmed TMC OA who received either corticosteroid injection or surgical treatment (trapeziectomy with ligament reconstruction and tendon interposition) were included in the study. Exclusion criteria were diseases other than TMC OA as the main condition at the time of clinical consultation, rheumatoid arthritis, concomitant surgery on other digits, legal incompetence, poor general health condition precluding study
Results
Of the 163 patients included in this analysis, 105 (64%) underwent surgery and 58 (36%) received corticosteroid injection treatment (Table 1). At one year, 94 surgical patients (89%) and 37 patients who received steroid injections (64%) were available for follow-up. In the surgical group, the MHQ pain score decreased from a mean of 65 (± 16) points before treatment to 24 (± 23) at one year (P ≤ .001), whereas patients with corticosteroid injections had before-treatment and one-year MHQ pain
Discussion
Analysis of patient expectations for treatment for TMC OA revealed that pain reduction was the most important reason why patients sought treatment, whereas improving the appearance of the hand was of minor importance. The anticipated fulfillment of expectations before treatment in the surgery group was higher than in the corticosteroid injection group. One year after initiation of treatment, more than three-quarters of surgically treated patients rated expectations to be mostly to completely
Acknowledgments
The authors thank Professor Dr Karin Niedermann from the Zurich University of Applied Sciences, Winterthur, Switzerland, for supporting this study, Professor Dr Thea Vliet Vlieland from Leiden University Medical Center for support in planning the study, and Dr Melissa Wilhelmi for copyediting the manuscript.
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