HbA1c Levels Do Not Affect Long-Term Outcome After Open Trigger Finger Release in Individuals With Diabetes Mellitus

Area of Science:

• Orthopedic Surgery
• Endocrinology
• Diabetes Mellitus Research

Background:

• Open trigger finger release (OTFR) surgery generally yields successful outcomes, even in patients with diabetes mellitus (DM).
• The influence of glycemic control on long-term results after OTFR in diabetic patients remains under investigation.
• This study specifically investigates the impact of elevated hemoglobin A1c (HbA1c) levels on patient-reported outcomes (PROs) following OTFR in individuals with type 1 (T1DM) and type 2 diabetes mellitus (T2DM).

Purpose of the Study:

• To determine if high HbA1c levels affect patient-reported outcomes after open trigger finger release (OTFR) surgery.
• To analyze the association between glycemic control (HbA1c levels) and long-term functional outcomes (QuickDASH, HQ-8) in diabetic patients undergoing OTFR.
• To assess the necessity of preoperative HbA1c testing for predicting long-term results of OTFR in patients with T1DM and T2DM.

Main Methods:

• Retrospective analysis of data from 2010-2020 from the Swedish hand surgery quality register (HAKIR) and the Swedish National Diabetes Register.
• Inclusion of adult patients (≥18 years) who underwent OTFR, stratified into tertiles based on mean HbA1c: optimal (≤48 mmol/mol), acceptable (48.1-64 mmol/mol), and poor (>64 mmol/mol).
• Assessment of PROs using QuickDASH and HQ-8 questionnaires at pre-operative, 3-month, and 12-month follow-ups; statistical analysis using adjusted linear mixed-model regression and Bonferroni correction.

Main Results:

• A total of 496 individuals with T1DM and 869 with T2DM underwent OTFR; 53% (n=710) completed at least one questionnaire.
• No statistically significant differences in QuickDASH or HQ-8 scores were observed at 12 months between the different HbA1c control groups for either T1DM or T2DM patients.
• The findings indicate that glycemic control, as measured by HbA1c levels, did not influence patient-reported outcomes 12 months after OTFR.

Conclusions:

• Poor glycemic control was not associated with adverse long-term patient-reported outcomes following open trigger finger release (OTFR).
• Preoperative HbA1c testing does not appear necessary for predicting the long-term success of OTFR in patients with diabetes mellitus.
• These results suggest that diabetic patients can expect similar functional recovery after OTFR regardless of their glycemic control status.