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The patient-based outcome of upper-extremity surgeries using the DASH questionnaire and the effect of disease activity of the patients with rheumatoid arthritis

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Abstract

The Disabilities of the Arm, Shoulder and Hand (DASH) is a standardized patient-based outcome measure, which assesses integrated upper-extremity disorders. The objectives of this study were to investigate subjective outcome after upper-extremity surgeries for the patients with rheumatoid arthritis (RA) using the DASH questionnaire (Japanese version) and to investigate the influence of disease activity on the surgical outcome using the Disease Activity Score (DAS) 28-CRP(4). Approximately 127 surgical procedures for the upper extremities in 127 patients with RA were recruited in this study. Surgeries were performed in 4 shoulders, 35 elbows, 60 wrists and 28 hands. The DASH score (disability/symptom score) was investigated just before surgery and at follow-up. The mean follow-up period after the surgery was 15 months on average (range, 6 to 24 months). The preoperative DASH score (disability/symptom score) 50 ± 23 (mean ± SD) decreased significantly to 38 ± 23 at the follow-up (n = 127, p < 0.01). Standardized response mean and effect size revealed a medium effect of −0.6 and −0.5. Patients with various degrees of disease activity improved and the improvements per se were comparable of preoperative disease activity and postoperative response to medical treatment. A favorable subjective outcome of rheumatoid upper-extremity surgeries can be anticipated under the good control of disease activity.

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References

  1. Henmi S, Yonenobu K, Masatomi T et al (2006) A biomechanical study of activities of daily living using neck and upper limbs with an optical three-dimensional motion analysis system. Mod Rheumatol 16:289–293

    Article  PubMed  Google Scholar 

  2. Hudak PL, Amadio PC, Bombardier C (1996) Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand). Am J Int Med 29:602–608

    Article  CAS  Google Scholar 

  3. Beaton DE, Katz JN, Fossel AH et al (2001) Measuring the whole or the parts? Validity, reliability, and responsiveness of the disabilities of the arm, shoulder and hand outcome measure in different region of the upper extremity. J Hand Ther 14:128–146

    PubMed  CAS  Google Scholar 

  4. Imaeda T, Toh S, Nakao Y, Nishida J et al (2005) Validation of the Japanese society for surgery of the hand version of the disability of the arm, shoulder, and hand questionnaire. J Orthop Sci 10:535–539

    Article  Google Scholar 

  5. van der Heijde DMFM, van’t Hof MA, van Riel PLCM et al (1990) Judging disease activity in clinical practice in rheumatoid arthritis: first step in the development of a disease activity score. Ann Rheum Dis 49:916–920

    Article  PubMed  Google Scholar 

  6. Prevoo MLL, van’t Hof MA, Kuper HH et al (1995) Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 38:44–48

    Article  PubMed  CAS  Google Scholar 

  7. Darrach W (1913) Partial excision of lower shaft of ulna for deformity following Colles’ fracture. Ann Surg 57:764–765

    Google Scholar 

  8. Sauvé L, Nouvelle KM (1936) Technique de traitement chirurgical de luxations rècidivantes isolees de l’extrèmitè infèrieure du cubitus. J Chir 47:589–594

    Google Scholar 

  9. Swanson AB (1972) Flexible implant arthroplasty for arthritic finger joints: rationale, technique, and results of treatment. J Bone Joint Surg 54A:435–455

    Google Scholar 

  10. SooHoo NF, McDonald AP, Seiler JG III et al (2002) Evaluation of the construct validity of the DASH questionnaire by correlation to the SF-36. J Hand Surg 27A:537–541

    Google Scholar 

  11. Offenbächer M, Ewert T, Sangha O et al (2003) Validation of a German version of the disabilities of arm, shoulder and hand questionnaire (DASH-G). Z Rheumatol 62:168–177

    Article  PubMed  Google Scholar 

  12. Hunsaker FG, Cioffi DA, Amadio PC et al (2002) The American Academy of Orthopaedic Surgeons outcomes instrument. Normative values from the general population. J Bone Joint Surg 84A:208–215

    Google Scholar 

  13. Jester A, Harth A, Germann G (2005) Measuring levels of upper-extremity in employed adults using the DASH questionnaire. J Hand Surg 30A:1074–1082

    Google Scholar 

  14. Gummesson C, Atroshi I, Ekdahl C (2003) The disabilities of the arm, shoulder and hand (DASH) outcome questionnaire: longitudinal validity and measuring self-rated health change after surgery. BMC Musculoskelet Disord 4:11

    Article  PubMed  Google Scholar 

  15. van Gestel AM, Prevoo MLL, van’t Hof MA et al (1996) Development and validation of the European league against rheumatism response criteria for rheumatoid arthritis. Comparison with the preliminary American Collage of Rheumatology and the World Health organization/International League Against Rheumatism Criteria. Arthritis Rheum 39:34–40

    Article  PubMed  Google Scholar 

  16. Husted JA, Cook RJ, Farewell VT et al (2000) Methods for assessing responsiveness: a critical review and recommendation. J Clin Epidemiol 53:459–568

    Article  PubMed  CAS  Google Scholar 

  17. Hildebrand KA, Patterson SD, Regan WD et al (2000) Functional outcome of semiconstrained total elbow arthroplasty. J Bone Joint Surg 82A:1379–1386

    Google Scholar 

  18. Angst F, John M, Pap G, Mannion AF et al (2005) Comprehensive assessment of clinical outcome and quality of life after total elbow arthroplasty. Arthritis Rheum 53:73–82

    Article  PubMed  Google Scholar 

  19. Angst F, Pap G, Mannion AF et al (2004) Comprehensive assessment of clinical outcome and quality of life after total shouder arthroplasty: usefulness and validity of subjective outcome measures. Arthritis Rheum 51:819–828

    Article  PubMed  Google Scholar 

  20. Felderhoff J, Wiemer P, Dronsella J et al (1999) The operative therapy of distal unstable radius fractures with dorsal and volar plates. A retrospective study with respect to the DASH-score system. Orthopäde 28:853–863

    PubMed  CAS  Google Scholar 

  21. Westphal T, Piatek S, Schubert S et al (2002) Reliability and validity of the upper limb DASH questionnaire in patients with distal radius fractures. Z orthop Ihre Grenzgeb 140:447–451

    Article  PubMed  CAS  Google Scholar 

  22. Kotsis SV, Chung KC (2005) Responsiveness of the Michigan hand outcomes questionnaire and the disabilities of the arm, shoulder and hand questionnaire in carpal tunnel surgery. J Hand Surg 30A:81–86

    Google Scholar 

  23. Murphy DM, Khoury JG, Imbriglia JE et al (2003) Comparison of arthroplasty and arthrodesis for the rheumatoid wrist. J Hand Surg 28A:570–576

    Google Scholar 

  24. Adey L, Ring D, Jupiter JB (2005) Health status after total wrist arthrodesis for posttraumatic arthritis. J Hand Surg 30A:932–936

    Google Scholar 

  25. Nyszkiewicz R, Neumann R (2001) Experiences with the Eaton-Littler procedure for ligament reconstruction for the painful thumb carpometacarpal joint. Handchir Mikrochir Plast Chir 33:424–430

    Article  PubMed  CAS  Google Scholar 

  26. Angst F, John M, Goldhahn J et al (2005) Comprehensive assessment of clinical outcome and quality of life after resection interposition arthroplasty of the thumb saddle joint. Arthritis Rheum 53:205–213

    Article  PubMed  Google Scholar 

  27. Chiari-Grisar C, Koller U, Stamm TA et al (2006) Performance of the disabilities of the arm, shoulder and hand outcome questionnaire and the Moberg picking up test in patients with finger joint arthroplasty. Arch Phys Med Rehabil 87:203–206

    Article  PubMed  Google Scholar 

  28. Smith-Petersen MN, Aufranc OE, Larson CB (1943) Useful surgical procedures for rheumatoid arthritis involving joints of the upper extremity. Arch Surg 46:764–770

    Google Scholar 

  29. Gschwend N (1980) Objective nature of the operations. In: Gschwend N (ed) Surgical treatment of rheumatoid arthritis. W.B.Saunders, Philadelphia, pp 18–24

    Google Scholar 

  30. Baumgartner H, Dovrak J, Grob D et al (1995) Staging of surgery in the upper limb. In: Baumgartner H, Dovrak J, Grob D et al (eds) Rheumatoid arthritis, Current trends in diagnostics, conservative treatment, and surgical reconstruction. Georg Thieme Verlag, Stuttgart, pp 161–168

    Google Scholar 

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Authors and Affiliations

  1. Deparment of Rheumatology, Niigata Rheumatic Center, 1-2-8 Honcho, Shibata city, Niigata, 957-0054, Japan

    Hajime Ishikawa, Akira Murasawa, Kiyoshi Nakazono, Asami Abe, Hiroshi Otani, Tahahiro Netsu, Takehito Sakai & Hiroe Sato

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  1. Hajime Ishikawa
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  2. Akira Murasawa
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  3. Kiyoshi Nakazono
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  4. Asami Abe
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  5. Hiroshi Otani
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  6. Tahahiro Netsu
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  7. Takehito Sakai
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  8. Hiroe Sato
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Correspondence to Hajime Ishikawa.

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Ishikawa, H., Murasawa, A., Nakazono, K. et al. The patient-based outcome of upper-extremity surgeries using the DASH questionnaire and the effect of disease activity of the patients with rheumatoid arthritis. Clin Rheumatol 27, 967–973 (2008). https://doi.org/10.1007/s10067-007-0830-8

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  • DOI: https://doi.org/10.1007/s10067-007-0830-8

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