Abstract
Purpose To determine thresholds in patient-reported outcome measures at baseline in patients
electing to undergo triangular fibrocartilage complex (TFCC) surgery to select patients
with clinically improved outcomes.
Methods The study cohort comprised consecutive patients who underwent open TFCC repair between
December 2011 and December 2018 in various clinics in the Netherlands. All patients
were asked to complete the patient-rated wrist evaluation (PRWE) questionnaire at
baseline as well as at 12 months postoperatively. The minimal clinically important
difference (MCID) for the PRWE was calculated to be 24 using an anchor-based method.
We compared patient, disease, and surgical characteristics between patients who did
and did not reach the MCID. The t -tests and chi-square tests were undertaken to test differences between outcomes and
satisfaction in patients who did or did not reach the MCID.
Results Patients (34%) who did not reach MCID had a longer history of complaints. The chances
of reaching the MCID for patients with a low PRWE score at baseline were slim. Of
patients with a PRWE score <34 at baseline, only 14% reached the MCID, whereas in
patients with a PRWE score of ≥34, 69% reached the MCID.
Conclusion A PRWE total score at baseline <34 is a strong signal to reconsider open surgery
of the TFCC because the chance of reaching a clinically meaningful outcome is slim.
Level of Evidence II.
Type of Study Therapeutic.
Keywords TFCC - triangular fibrocartilage - PROM - surgery - open reinsertion - outcome - prognostic
factors
