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Updated: Sep 19, 2025

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

Brandon Leon1, Samir Kaveeshwar1, Yanni Kevas1

  • 1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, MD.

Journal of Hand Surgery Global Online
|June 17, 2025
PubMed
Summary
This summary is machine-generated.

Patient expectations before hand and wrist surgery correlate with outcomes but do not independently predict them. This study analyzed 253 patients to understand the relationship between preoperative expectations and 2-year patient-reported outcomes.

Keywords:
Hand surgeryPROMISPatient expectationsPatient-reported outcomes

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Area of Science:

  • Orthopedic Surgery
  • Patient-Reported Outcomes Research
  • Musculoskeletal Health

Background:

  • Preoperative expectations are crucial in patient satisfaction and outcomes after surgery.
  • Understanding factors influencing patient-reported outcomes (PROs) is vital for improving surgical care.
  • Hand and wrist surgeries often involve significant functional and quality-of-life implications.

Purpose of the Study:

  • To investigate the relationship between preoperative expectations and 2-year PROs in patients undergoing hand and wrist surgery.
  • To determine if preoperative expectations are predictive of long-term PROs.
  • To identify factors associated with preoperative expectations in this patient cohort.

Main Methods:

  • Prospective enrollment of 253 patients in an orthopedic registry.
  • Measurement of preoperative expectations using the Musculoskeletal Outcomes Data Evaluation and Management System.
  • Assessment of multiple PROs, including PROMIS domains and the Brief Michigan Hand Questionnaire, at baseline and 2 years post-surgery.

Main Results:

  • Patients generally reported high preoperative expectations.
  • Worse preoperative expectations were linked to smoking, legal claims, prior surgeries, and poorer baseline physical function, fatigue, and anxiety.
  • While bivariate analysis showed associations between greater expectations and better 2-year outcomes, multivariable analysis found no independent predictive value.

Conclusions:

  • Preoperative expectations are associated with 2-year patient-reported outcomes in hand and wrist surgery.
  • These expectations are not independently predictive of long-term outcomes when controlling for other variables.
  • Further research may explore the mechanisms behind this association and its clinical implications.