Comparing Patient-Reported Outcomes on Three-Ligament Tenodesis between Partial and Complete Scapholunate Ligament Injuries: A Cohort Study

Stefanie N Hakkesteegt; Mark J W van der Oest; Kas N Dullemans; Liron S Duraku; Caroline A Hundepool; Ruud W Selles; Reinier Feitz; J Michiel Zuidam; Hand-Wrist Study Group

doi:10.1016/j.jhsa.2022.09.012

Comparing Patient-Reported Outcomes on Three-Ligament Tenodesis between Partial and Complete Scapholunate Ligament Injuries: A Cohort Study

J Hand Surg Am. 2022 Nov 28:S0363-5023(22)00548-2. doi: 10.1016/j.jhsa.2022.09.012. Online ahead of print.

Authors

Stefanie N Hakkesteegt¹, Mark J W van der Oest¹, Kas N Dullemans¹, Liron S Duraku², Caroline A Hundepool¹, Ruud W Selles³, Reinier Feitz⁴, J Michiel Zuidam⁵; Hand-Wrist Study Group

Collaborators

Affiliations

¹ Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands.
² Department of Plastic, Reconstructive and Hand Surgery, Amsterdam UMC, Amsterdam, The Netherlands.
³ Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Rehabilitation Medicine, Erasmus Medical Centre Rotterdam, The Netherlands.
⁴ Hand and Wrist Center, Xpert Clinics, Amsterdam, The Netherlands.
⁵ Department of Plastic, Reconstructive and Hand Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands. Electronic address: j.zuidam@erasmusmc.nl.

PMID: 36456426
DOI: 10.1016/j.jhsa.2022.09.012

Abstract

Purpose: Multiple studies report outcomes after 3-ligament tenodesis (3-LT) in treating traumatic scapholunate interosseous ligament injury (SLIL). However, investigators do not differentiate between patients with partial or complete SLIL injury. The relation between the extent of SLIL disruption and surgical outcomes and if this should be considered when treating a patient with SLIL injury remains unknown. We aimed to evaluate differences in patient-rated wrist evaluation (PRWE) scores, satisfaction and return to work between patients with partial or complete chronic traumatic SLIL injury treated with 3 ligament tenodesis at 12 months after surgery.

Methods: All patients with chronic SLIL injury (partial and complete) who were treated with 3-LT at our clinic and received the same postoperative management between December 2011 and December 2019 were studied. Only patients who had completed the PRWE and return to work questionnaires preoperatively and 12 months after surgery were included. Patients were allocated to the partial (classified as Geissler 2 or 3) or complete SLIL injury group (classified as Geissler 4) by retrospectively assessing wrist arthroscopy reports.

Results: Thirty-nine patients with partial and 90 with complete SLIL injuries were included. At 1-year follow-up, PRWE scores had significantly improved in both groups. When adjusting for clinical baseline characteristics, there was no statistically significant difference between patients with partial or complete SLIL injury. Patients with complete SLIL injury had a 70% higher return to work within the first 12 months after 3-LT; however, satisfaction with the treatment result was similar for both study groups 1 year after surgery.

Conclusions: Patients with complete and partial traumatic SLIL injury report better PRWE total scores at 12 months after 3-LT, but there was no statistically significant difference between the groups in PRWE scores or satisfaction with the treatment result.

Type of study/level of evidence: Therapeutic IV.

Keywords: Arthroscopy; patient-reported outcomes; scapholunate ligament injury; three-ligament tenodesis.