A Cost-Effectiveness Analysis of Corticosteroid Injections and Open Surgical Release for Trigger Finger

Zhuang, Thompson; Wong, Sandy; Aoki, Rhonda; Zeng, Edric; Ku, Seul; Kamal, Robin N.

doi:10.1016/j.jhsa.2020.04.008

Cited by 9 publications

(8 citation statements)

References 42 publications

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“…Cost of treatment can affect recommendations that a provider makes. Zhuang et al [ 39 ] evaluated cost effectiveness of cortisone injections vs open trigger finger release and reported that, from a healthcare payer perspective, offering 3 cortisone injections before surgery is a cost-effective strategy[ 39 ]. Kerrigan and Stanwix examined cost of treatment and concluded that the least costly treatment would be 2 injections before surgery[ 40 ].…”

Section: Discussionmentioning

confidence: 99%

Patient preference for trigger finger treatment

Blough¹,

Najdawi²,

Kuschner³

2022

World J Orthop

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BACKGROUND Trigger finger is a common disorder of the hand that can cause disabling symptoms. Treatment options range from conservative management with observation and splinting, to surgical release, but there is currently not a consensus on a treatment algorithm. AIM To determine patient preference for the treatment of trigger finger using an online survey. METHODS An online crowdsourcing platform, Amazon Mechanical Turk, was used to recruit participants for this study. Participants were led through a scenario in which they were diagnosed with trigger finger. They were then asked to rank their preference of treatment options from the following: Observation, splinting, corticosteroid injection, surgery. The results of the surveys were then analyzed using R software. RESULTS Of 323 participants completed the survey. 7 participants were excluded because they failed to correctly answer the attention question, leaving 316 participants whose results were included. As a first choice for treatment 117 (37%) of the included participants chose observation, 86 (27%) chose splinting, 61 (19%) chose corticosteroid injection, and 52 (16%) chose surgery. The mean rank for observation was 2.26, for splinting was 2.30, for corticosteroid injection was 2.53, and for surgery was 2.91. The ranking of each treatment option was statistically different ( P value < 0.05) from the others except for observation and splinting. CONCLUSION The practice of shared decision making with patients is imperative to providing the best care possible. The results from this study, especially the preference for less invasive treatment, may help providers better frame discussion around treatment options of trigger fingers. This in turn, may increase patient satisfaction in the treatment of trigger finger.

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Section: Discussionmentioning

confidence: 99%

Patient preference for trigger finger treatment

Blough¹,

Najdawi²,

Kuschner³

2022

World J Orthop

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“…We are aware of three previous studies that evaluated the ICER for various hand conditions. 4,6,41 An ICER of £11,000 (= USD 15,000) /QALY was established for patients with Dupuytren's disease based on the comparison of two surgical methods and modelled data. 4 A second study also using modelling techniques compared a therapy regimen including up to three steroid injections before surgery versus surgery or immediate open surgical release for the treatment of trigger finger and calculated an ICER of USD 118,827/QALY.…”

Section: Discussionmentioning

confidence: 99%

“…4 A second study also using modelling techniques compared a therapy regimen including up to three steroid injections before surgery versus surgery or immediate open surgical release for the treatment of trigger finger and calculated an ICER of USD 118,827/QALY. 41 The third study focused on the costs per unit gain of functional improvement in patients with rheumatoid arthritis undergoing metacarpophalangeal arthroplasty compared to nonsurgical treatment. 6 The reported ICERs were less than USD 1,150 per gained unit in the MHQ and USD 50,000 to USD 150,000 per gained unit using the generic Arthritis Impact Measurement Scale 2; these cost-effectiveness values are not directly comparable to ICERs of costutility studies, where costs per QALY gained are determined.…”

Section: Discussionmentioning

confidence: 99%

Cost-Utility Analysis of Thumb Carpometacarpal Resection Arthroplasty: A Health Economic Study Using Real-World Data

Grobet

Audigé

Eichler

et al. 2022

The Journal of Hand Surgery

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“…The results were sensitive to the probability of injection site fat necrosis, success rate of steroid injections, time to symptom relief after a steroid injection, and cost of treatment. 66 Non-rheumatoid flexor tenosynovitis resolved in 100% of a small group of patients treated with CS injection and persistent benefit was noted in 93%. 67 In a recent comprehensive literature review on common chronic pain conditions of the hand was found that when the etiology of the pain is inflammatory, CS injections provide significant pain relief and increased functionality and that 10–20 mg of methylprednisolone or triamcinolone injections are the most common steroids used for small joint pain.…”

Section: Current Treatment Strategiesmentioning

confidence: 99%

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

Carriero

Lubrano

Valentina

et al. 2021

Therapeutic Advances in Musculoskeletal

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Dactylitis – a hallmark clinical feature of psoriatic arthritis (PsA) – that occurs in 30–50% of PsA patients, is a marker of disease severity for PsA progression, an independent predictor of cardiovascular morbidity and impairs the motor functions of PsA patients. There is a paucity of evidence for the treatment due to the absence of randomized controlled trials assessing dactylitis as a primary endpoint and current practice arises from the analysis of dactylitis as a secondary outcome. Corticosteroid (CS) injections for dactylitis in PsA patients are a therapeutic treatment option for patients with isolated dactylitis or for patients with flares in tendon sheaths, despite stable and effective systemic treatment. The aim of this narrative review is to briefly illustrate the clinical aspects of dactylitis in PsA, the imaging and clinimetric tools used to diagnose and monitor dactylitis, the current treatment strategies and principally to provide a comprehensive picture of the clinical efficacy and safety with ultrasound-guide and blind techniques of CS injections for dactylitis in PsA patients.

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A Cost-Effectiveness Analysis of Corticosteroid Injections and Open Surgical Release for Trigger Finger

Cited by 9 publications

References 42 publications

Patient preference for trigger finger treatment

Patient preference for trigger finger treatment

Cost-Utility Analysis of Thumb Carpometacarpal Resection Arthroplasty: A Health Economic Study Using Real-World Data

Corticosteroid injection treatment for dactylitis in psoriatic arthritis

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