Durability of wrist denervation for osteoarthritis: a multicentre outcome study
Esmee Kwee, Niek J Nieuwdorp, Camille Blaaker, Jelle M Zuidam, , Richard Arjen Michiel Blomme, Jeronimus (Jeroen) Maria Smit, Kennard Harmsen, Gertjan Halbesma, Guus Maarten Vermeulen, Johannes (Hans) Pieter de Schipper, Jeroen Hein van Uchelen, Oliver Theodor Zöphel, John Sebastiaan Souer, Lisa Esteban Lopez, Alexandra Fink, Rob van Huis, Pierre-Yves Alain Adriaan Pennehouat, Karin Schoneveld, Grada Renée Arends, Reinier Feitz, Lisa Hoogendam, Steven Eric Ruden Hovius, Yara Eline van Kooij, Jaimy Emerentiana Koopman, Mark Johannes Willem van der Oest, Willemijn Anna de Ridder, Ruud Willem Selles, Liz-Tipper Sikking, Harm Pieter Slijper, Marloes Hendrina Paulina ter Stege, Joris Sebastiaan Teunissen, Robbert Maarten Wouters, Nina Louisa Loos, Nienke Helena Adriana Mendelaar, Lyse van Wijk, Ward Rogier Bijlsma, Joost W Colaris, Liron S Duraku, Egberta Petronella, Adriana (Brigitte) van der Heijden, Caroline Anna Hundepool, Jelle Michiel Zuidam, Caroline A HundepoolIntroduction:
Traditional surgical treatments for wrist osteoarthritis, such as arthrodesis or arthroplasty, are invasive and irreversibly compromise joint motion. Wrist denervation offers a less invasive alternative aimed at pain relief while preserving mobility. However, its durability remains uncertain. The aim of the study is to evaluate whether wrist denervation prevents further osteoarthritis-related wrist surgery in the mid- to long-term.
Methods:
This prospective multicentre study included patients with symptomatic wrist osteoarthritis who underwent wrist denervation after failed non-surgical treatment between 2012 and 2024, with a minimum follow-up of 12 months. The primary outcome was procedure success, defined as the proportion of wrists not requiring further osteoarthritis-related surgery. Secondary outcomes included visual analogue scale (0–100) scores for pain and function, patient satisfaction and willingness to repeat the procedure.
Results:
One hundred and twelve patients (114 wrists) were included. At a median follow-up of 4 years (1–13), 86% of wrists did not undergo further osteoarthritis-related surgery after denervation. Most reoperations occurred within 2 years. Mean visual analogue scale pain score at rest significantly improved from 48 (SD 28) preoperatively to 26 (SD 29) (reduction: 22 points). Mean visual analogue scale function significantly improved from 55 (SD 26) to 69 (SD 24) (improvement: 14 points). Patient satisfaction was rated as good or excellent in 60%, and 82% were willing to undergo the same treatment again.
Conclusion:
Wrist denervation yields durable symptom relief and can, in many cases (86%), prevent further osteoarthritis-related surgery in patients with wrist osteoarthritis over a median 4 year follow-up.
Level of Evidence:
II