Durability of wrist denervation for osteoarthritis: a multicentre outcome study

Abstract

INTRODUCTION: 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.