Revision rate and long-term outcome after partial wrist denervation in wrist osteoarthritis

Abstract

Introduction:

This prospective, one-group, interventional study assessed 5 year survival and outcomes after partial wrist denervation for painful wrist osteoarthritis. The primary outcome was the proportion of patients who did not require further surgery (survival rate). Secondary outcomes included patient-reported measures, objective function and radiographic progression.

Methods:

Sixty consecutive patients who underwent neurectomy of the posterior and anterior interosseous nerves between 2018 and 2020 were included. Survival was analysed using Kaplan–Meier and Cox regression. Patient-reported outcomes, strength and range of motion were assessed at baseline, 1 year and 5 years using generalized estimating equations. Radiographs were reviewed at baseline and 5 years later.

Results:

At 1 and 5 years, the survival probabilities were estimated to be 73 and 57%, respectively. In patients who did not require additional surgery, DASH improved by 15 points, Patient-reported Wrist Evaluation by 23 points, pain at rest by 2 points and pain on load by 3 points. No significant changes were observed in the European Quality of Life Three Dimensions or objective function. Radiographic progression was observed in 21% of patients.

Conclusion:

In summary, less than half of the patients underwent revision surgery within 5 years and those who did not require further procedures experienced significant improvements in patient-reported outcomes. Additional studies are required to confirm these findings and investigate who may benefit from partial wrist denervation.

Level of evidence:

III