Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery

Purpose: The purpose of this paper was to use validated instruments to identify if there is a relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing hand and wrist surgery. We hypothesized that preoperative expectations would be predictive of 2-yea...

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Main Authors: Brandon Leon, MD, Samir Kaveeshwar, MD, Yanni Kevas, MD, Daniel Rivkin, BS, Matheus B. Schneider, MD, Leah E. Henry, MD, Evan L. Honig, MD, Michael A. McCurdy, MD, Raymond A. Pensy, MD, Christopher G. Langhammer, MD, Ralph Frank Henn, III, MD
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Journal of Hand Surgery Global Online
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Online Access:http://www.sciencedirect.com/science/article/pii/S2589514125000830
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author Brandon Leon, MD
Samir Kaveeshwar, MD
Yanni Kevas, MD
Daniel Rivkin, BS
Matheus B. Schneider, MD
Leah E. Henry, MD
Evan L. Honig, MD
Michael A. McCurdy, MD
Raymond A. Pensy, MD
Christopher G. Langhammer, MD
Ralph Frank Henn, III, MD
author_facet Brandon Leon, MD
Samir Kaveeshwar, MD
Yanni Kevas, MD
Daniel Rivkin, BS
Matheus B. Schneider, MD
Leah E. Henry, MD
Evan L. Honig, MD
Michael A. McCurdy, MD
Raymond A. Pensy, MD
Christopher G. Langhammer, MD
Ralph Frank Henn, III, MD
author_sort Brandon Leon, MD
collection DOAJ
description Purpose: The purpose of this paper was to use validated instruments to identify if there is a relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing hand and wrist surgery. We hypothesized that preoperative expectations would be predictive of 2-year PROs in hand and wrist surgery patients. Methods: In total, 253 patients who underwent hand and wrist surgery were enrolled in a prospective orthopedic registry. The Musculoskeletal Outcomes Data Evaluation and Management System was used to measure preoperative expectations. At both baseline and 2 years after surgery, patients completed multiple questionnaires with multiple PROs, including six domains of the PROs measurement information system (PROMIS) and the Brief Michigan Hand Questionnaire. Results: Overall, patients undergoing hand and wrist surgery had high expectations. Worse preoperative expectations were significantly associated with smoking, worker’s compensation or other legal claim, a greater number of prior surgeries, and worse baseline PROMIS physical function, fatigue, and anxiety (P < .05). Bivariate analysis indicated that greater preoperative expectations were associated with better 2-year PROMIS physical function, PROMIS pain interference, PROMIS fatigue, PROMIS depression, numeric pain scale, surgical satisfaction questionnaire scores, met expectations, and the Brief Michigan Hand Questionnaire (P < .05). Multivariable analysis controlling for confounding variables revealed that preoperative expectations were not independently predictive of any 2-year PROs. Conclusions: Patients’ preoperative expectations are associated with, but not independently predictive of, 2-year patient-reported outcomes. Type/of study/level of evidence: Prognostic IIB.
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spelling doaj-art-c18da2c1140c4d1f9fa1cca6dcf1d2572025-08-20T02:32:30ZengElsevierJournal of Hand Surgery Global Online2589-51412025-07-017410076310.1016/j.jhsg.2025.100763Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist SurgeryBrandon Leon, MD0Samir Kaveeshwar, MD1Yanni Kevas, MD2Daniel Rivkin, BS3Matheus B. Schneider, MD4Leah E. Henry, MD5Evan L. Honig, MD6Michael A. McCurdy, MD7Raymond A. Pensy, MD8Christopher G. Langhammer, MD9Ralph Frank Henn, III, MD10Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MDDepartment of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD; Corresponding author: Ralph Frank Henn III, MD, Professor and Chair of Orthopaedics, University of Maryland Rehabilitation and Orthopaedic Institute, 2200 Kernan Drive, Baltimore, MD 21207.Purpose: The purpose of this paper was to use validated instruments to identify if there is a relationship between preoperative expectations and patient-reported outcomes (PROs) in patients undergoing hand and wrist surgery. We hypothesized that preoperative expectations would be predictive of 2-year PROs in hand and wrist surgery patients. Methods: In total, 253 patients who underwent hand and wrist surgery were enrolled in a prospective orthopedic registry. The Musculoskeletal Outcomes Data Evaluation and Management System was used to measure preoperative expectations. At both baseline and 2 years after surgery, patients completed multiple questionnaires with multiple PROs, including six domains of the PROs measurement information system (PROMIS) and the Brief Michigan Hand Questionnaire. Results: Overall, patients undergoing hand and wrist surgery had high expectations. Worse preoperative expectations were significantly associated with smoking, worker’s compensation or other legal claim, a greater number of prior surgeries, and worse baseline PROMIS physical function, fatigue, and anxiety (P < .05). Bivariate analysis indicated that greater preoperative expectations were associated with better 2-year PROMIS physical function, PROMIS pain interference, PROMIS fatigue, PROMIS depression, numeric pain scale, surgical satisfaction questionnaire scores, met expectations, and the Brief Michigan Hand Questionnaire (P < .05). Multivariable analysis controlling for confounding variables revealed that preoperative expectations were not independently predictive of any 2-year PROs. Conclusions: Patients’ preoperative expectations are associated with, but not independently predictive of, 2-year patient-reported outcomes. Type/of study/level of evidence: Prognostic IIB.http://www.sciencedirect.com/science/article/pii/S2589514125000830Hand surgeryPatient expectationsPatient-reported outcomesPROMIS
spellingShingle Brandon Leon, MD
Samir Kaveeshwar, MD
Yanni Kevas, MD
Daniel Rivkin, BS
Matheus B. Schneider, MD
Leah E. Henry, MD
Evan L. Honig, MD
Michael A. McCurdy, MD
Raymond A. Pensy, MD
Christopher G. Langhammer, MD
Ralph Frank Henn, III, MD
Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
Journal of Hand Surgery Global Online
Hand surgery
Patient expectations
Patient-reported outcomes
PROMIS
title Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
title_full Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
title_fullStr Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
title_full_unstemmed Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
title_short Preoperative Expectations Do Not Independently Predict Two-Year Patient-Reported Outcomes Following Hand and Wrist Surgery
title_sort preoperative expectations do not independently predict two year patient reported outcomes following hand and wrist surgery
topic Hand surgery
Patient expectations
Patient-reported outcomes
PROMIS
url http://www.sciencedirect.com/science/article/pii/S2589514125000830
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