Epidemiology and Outcomes of Upper Limb Surgery: Analysis of Routine Data

Summary

Surgery is a common treatment type for damaged joints, tendons and nerves in the upper limb where conservative measures are inappropriate or have failed. These conditions are common and result in significant levels of pain and functional disability. The investigators are conducting a broad ranging study of variation in the provision of surgical treatment and factors affecting outcomes after surgical treatment of upper limb conditions. This will be a population-based study of all patients undergoing surgical treatment funded by the National Health Service (NHS) of England over a nineteen-year period. This study will help to understand the factors associated with a poor outcome following surgery, which can be shared with patients considering treatment options. The investigators will also document current and future health service burden associated with commonly performed surgical procedures including complications and repeat operations.

Conditions

• Osteoarthritis
• Dislocations
• Inflammatory Arthritis
• Rotator Cuff Tear
• Shoulder Dislocation
• Upper Limb Nerve Lesion
• Shoulder Arthropathy
• Elbow Arthropathy
• Wrist Arthropathy
• Arthropathy Unspecified, Involving Hand
• Fracture, Shoulder
• Fracture Elbow
• Fracture Wrist and Hand
• Dupuytren Contracture
• Impingement Syndrome, Shoulder
• Trigger Digit
• Avascular Necrosis

Interventions

PROCEDURE

Shoulder arthroplasty

Any form of joint replacement of the glenohumeral joint including prosthetic and excision.

PROCEDURE

Elbow arthroplasty

Any form of joint replacement of the elbow joint including prosthetic and excision.

PROCEDURE

Hand and wrist arthroplasty

Any form of joint replacement of joints of the hand and wrist including prosthetic and excision.

PROCEDURE

Nerve decompression

Open or endoscopic release of peripheral nerve entrapment - subdivided by anatomical site of compression. Specific subgroups will include carpal tunnel and cubital tunnel release.

PROCEDURE

Tendon repair

Open or arthroscopic repair or reconstruction of tendons of the shoulder, hand and upper limb in general.

PROCEDURE

Joint stabilisation

Any procedure designed to increase stability of a joint, including soft tissue and bony blocking procedures.

PROCEDURE

Excision/division/release of palmar fascia

Any procedure performed for treatment of Dupuytren's contracture.

PROCEDURE

Surgical fixation of fractures

Any internal or external fixation of upper limb fractures - analysed by anatomical site.

PROCEDURE

Soft tissue release/debridement/excision

Any removal or release of soft tissue for treatment of stiffness, functional impairment or pain. Specific subgroups will include trigger finger release, subacromial surgery and surgery for frozen shoulder.

PROCEDURE

Intra-articular injection

Any intra-articular injection

Sponsors & Collaborators

• Wellcome Trust

  collaborator OTHER

• National Institute for Health Research, United Kingdom

  collaborator OTHER_GOV

• Arthritis Research UK

  collaborator OTHER

• University of Oxford

  lead OTHER

Principal Investigators

• Dominic Furniss, DPhil · University of Oxford

Eligibility

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

1998-04-06

Primary Completion

2017-04-05

Completion

2017-04-05