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Patients' experiences before and after total wrist fusion or total wrist arthroplasty:A qualitative study of patients with wrist osteoarthritis

Larsson, Sara LU ; Carlsson, Ingela K. LU ; Rosberg, Hans Eric LU ; Björkman, Anders LU and Brogren, Elisabeth LU (2022) In Journal of Hand Therapy 35(1). p.41-50
Abstract

Introduction: For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative. Purpose: To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life. Study Design: Qualitative descriptive. Methods: A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using... (More)

Introduction: For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative. Purpose: To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life. Study Design: Qualitative descriptive. Methods: A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using qualitative content analysis. Results: Four categories are described: the problematic wrist, the breakpoint, appraisal of the results, and adaptation to challenges in everyday life. Pain relief was the primary expectation of surgery, and involvement in the discussion regarding different surgical options had a positive effect on the appraisal of results. The participants' ability to perform tasks in everyday life appeared to be more related to their level of pain than the range of wrist motion. Successful coping strategies were developed, enabling the participants to become more independent and adapt to challenges in daily life. Conclusions: Previous surgical experiences, occupation, and amount of wrist motion influenced the participants' expectations, surgical choice with either a TWF or a TWA, and the appraisal of results. The findings contribute valuable insights to both surgeons and hand therapists about the importance of having the patient's individual expectations and needs in focus.

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author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Qualitative study, Total wrist arthroplasty, Total wrist fusion, Wrist osteoarthritis
in
Journal of Hand Therapy
volume
35
issue
1
pages
41 - 50
publisher
Elsevier
external identifiers
  • pmid:33279364
  • scopus:85097106979
ISSN
0894-1130
DOI
10.1016/j.jht.2020.10.004
language
English
LU publication?
yes
id
b2479164-7c36-403a-929a-486d72df057e
date added to LUP
2021-01-11 16:59:04
date last changed
2024-06-13 04:17:26
@article{b2479164-7c36-403a-929a-486d72df057e,
  abstract     = {{<p>Introduction: For patients with advanced wrist osteoarthritis (OA), total wrist fusion (TWF) is the standard surgical treatment, although total wrist arthroplasty (TWA) has become a plausible motion-preserving alternative. Purpose: To explore patients' experiences of living with advanced wrist OA before and after surgery with either a TWF or a TWA. Furthermore, we wanted to explore the expectations of surgery, appraisal of results, and the adaptation strategies used to overcome challenges in everyday life. Study Design: Qualitative descriptive. Methods: A purposive sample of 13 patients with advanced wrist OA surgically treated with TWF (n = 7) or TWA (n = 6) was recruited. Semistructured interviews were conducted and analyzed using qualitative content analysis. Results: Four categories are described: the problematic wrist, the breakpoint, appraisal of the results, and adaptation to challenges in everyday life. Pain relief was the primary expectation of surgery, and involvement in the discussion regarding different surgical options had a positive effect on the appraisal of results. The participants' ability to perform tasks in everyday life appeared to be more related to their level of pain than the range of wrist motion. Successful coping strategies were developed, enabling the participants to become more independent and adapt to challenges in daily life. Conclusions: Previous surgical experiences, occupation, and amount of wrist motion influenced the participants' expectations, surgical choice with either a TWF or a TWA, and the appraisal of results. The findings contribute valuable insights to both surgeons and hand therapists about the importance of having the patient's individual expectations and needs in focus.</p>}},
  author       = {{Larsson, Sara and Carlsson, Ingela K. and Rosberg, Hans Eric and Björkman, Anders and Brogren, Elisabeth}},
  issn         = {{0894-1130}},
  keywords     = {{Qualitative study; Total wrist arthroplasty; Total wrist fusion; Wrist osteoarthritis}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{41--50}},
  publisher    = {{Elsevier}},
  series       = {{Journal of Hand Therapy}},
  title        = {{Patients' experiences before and after total wrist fusion or total wrist arthroplasty:A qualitative study of patients with wrist osteoarthritis}},
  url          = {{http://dx.doi.org/10.1016/j.jht.2020.10.004}},
  doi          = {{10.1016/j.jht.2020.10.004}},
  volume       = {{35}},
  year         = {{2022}},
}