Preoperative Indicators of the Effectiveness of Surgical Release in Patients with de Quervain Disease: A Prospective Cohort Study.

BACKGROUND

A significant proportion of patients report persistent pain after surgical release for de Quervain disease (DQ). This study aimed to investigate the effectiveness of a surgical release for DQ and to identify the preoperative factors associated with pain after a surgical release for DQ.

METHODS

This prospective cohort study included 707 patients who underwent surgical release and completed a visual analogue scale questionnaire (VAS; range 0 to 100). We used a paired t test to analyze the effectiveness of the surgical release on pain at 3 months postoperatively compared with the preoperative measure. A hierarchical multivariable linear regression model was created to investigate the contribution of patient-related and disease-related characteristics to postoperative pain.

RESULTS

All VAS domains showed improvement after surgical release. On average, the mean VAS pain decreased by 44 points (95% CI, 42, 46). Smoking (B = 6.37; P < 0.01), younger age (B = -0.35; P < 0.01), longer duration of complaints (B = 0.13; P < 0.01), concomitant surgery (B = 14.40; P < 0.01), and higher VAS pain scores at intake (B = 0.15; P < 0.01) were associated with worse VAS pain scores postoperatively. Together, the variables explained 11% of the variance in mean VAS pain score at 3 months follow-up.

CONCLUSIONS

This study confirms that surgical treatment for DQ significantly reduces patient-reported pain. Smoking, younger age, concomitant surgery, duration of complaints, and higher VAS pain scores at intake are associated with worse patient-reported pain 3 months after surgical release. However, the small effects suggest that these factors should not be considered the only important factors.

CLINICAL QUESTION/LEVEL OF EVIDENCE: Risk, III.