Article

Wrist pain is common. People with persistent pain commonly undergo arthroscopic
investigation. Little is known about the prognosis or prognostic factors for
these patients. The purpose of the study was to evaluate prognosis and prognostic
factors for pain and functional disability in patients with persistent wrist pain
who proceed to arthroscopic investigation.
The study design used was a
prospective cohort study. One hundred and five consecutive participants who
underwent arthroscopic investigation for undiagnosed wrist pain for at least
four-week duration were recruited. Patient-rated wrist and hand evaluation
(PRWHE) scores were determined at baseline (before arthroscopy) and one year
after arthroscopy. One-year follow-up data were obtained for 97 (92%) of 105
participants. Mean PRWHE total score declined from 49 of 100 (standard deviation
[SD] 18.5) at baseline to 26 of 100 (SD 20.4) at one year. Two prognostic factors
were identified: baseline PRWHE and duration of symptoms. These factors explained
19% and 5% of the variability in the final PRWHE score, respectively. Results of
provocative wrist tests and arthroscopic findings did not significantly
contribute to prognosis in this cohort. This study provides the first robust
evidence of the prognosis of persistent wrist pain. Participants who underwent
arthroscopic investigation for persistent wrist pain improved on average by
approximately 50% at one year; however, most continued to have some pain and
disability. Duration of pain and PRWHE at baseline explained 24% of the one-year PRWHE score. LEVEL OF EVIDENCE : Level 2.
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Langue : ANGLAIS