Clinical trial · Observational
Epidemiology and Outcomes of Upper Limb Surgery: Analysis of Routine Data
The Role of Patient Factors, Surgical Factors and Hospital Factors Upon Patient Outcomes and NHS Costs in the Treatment of Upper Limb Musculoskeletal Conditions: Spatial and Iongitudinal Analysis of Routine Data
- Source
- ClinicalTrials.gov
- Retrieved
- Sep 8, 2026
- Layer
- normalized (units and labels harmonized; values unchanged)
- Run
- ING-CLINICALTRIALS-20260908-000001
Summary
Brief summary (as posted)
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
Conditions (17)
Free-text conditions as registered, with the CancerIndex entity they were reconciled to and the match type.
| Condition (as posted) | Mapped entity | Match | Confidence |
|---|---|---|---|
| Arthropathy Unspecified, Involving Hand | — | UNRESOLVED | — |
| Avascular Necrosis | — | UNRESOLVED | — |
| Dislocations | — | UNRESOLVED | — |
| Dupuytren Contracture | Palmar Fibromatosis | ALIAS | 0.90 |
| Elbow Arthropathy | — | UNRESOLVED | — |
| Fracture Elbow | — | UNRESOLVED | — |
| Fracture, Shoulder | — | UNRESOLVED | — |
| Fracture Wrist and Hand | — | UNRESOLVED | — |
| Impingement Syndrome, Shoulder | — | UNRESOLVED |
Interventions
Interventions (10)
| Intervention | Type | Mapped drug | Match |
|---|---|---|---|
| Elbow arthroplasty | Procedure | — | UNRESOLVED |
| Excision/division/release of palmar fascia | Procedure | — | UNRESOLVED |
| Hand and wrist arthroplasty | Procedure | — | UNRESOLVED |
| Intra-articular injection | Procedure | — | UNRESOLVED |
| Joint stabilisation | Procedure | — | UNRESOLVED |
| Nerve decompression | Procedure | — | UNRESOLVED |
| Shoulder arthroplasty | Procedure | — | UNRESOLVED |
| Soft tissue release/debridement/excision | Procedure | — | UNRESOLVED |
Design
Arms and outcomes
Arms (0)
[]Primary outcomes (3)
- measure
- Revision and reoperation
- timeFrame
- 1998-2017
- description
- Estimated at annual increments and standardised lifetime risk
- measure
- Treatment volume: time series
- timeFrame
- 1998-2017
- description
- Crude and adjusted for population by age/sex
- measure
- Treatment volume: geospatial patterns
- timeFrame
- 1998-2017
- description
- Mapped according to residence and NHS organisation boundaries
Secondary outcomes (4)
- measure
Eligibility
Eligibility (as posted)
- Sex
- All
Show eligibility criteria text
Inclusion Criteria: 1. Condition affecting one of: * Shoulder * Elbow * Wrist * Hand AND 2. All patients treated with surgery for any of the following: * Osteoarthritis * Inflammatory arthritis * Any other cause of arthropathy * Tendon tears * Peripheral neuropathy * Fractures and/or dislocations * Instability OR 3. Any arthroplasty surgery using a prosthesis Exclusion Criteria: * Patients registering a "type 2 opt out" - withholding NHS data from research use.
References
Publications (6)
- DERIVEDRees JL, Craig R, Nagra N, Baldwin M, Lane JCE, Price A, Beard DJ, Abram S, Judge A, Prieto-Alhambra D, Furniss D, Carr AJ. Serious adverse event rates and reoperation after arthroscopic shoulder surgery: population based cohort study. BMJ. 2022 Jul 6;378:e069901. doi: 10.1136/bmj-2021-069901. PMID 35938625
- DERIVEDAlser O, Abram SGF, Craig RS, Lane JCE, Shaw AV, Prats-Uribe A, Rees JL, Prieto-Alhambra D, Furniss D. Temporal Trends and Geographical Variation in Dupuytren Disease Surgery in England: A Population-Based Cohort Study. Ann Plast Surg. 2021 Sep 1;87(3):265-270. doi: 10.1097/SAP.0000000000002734. PMID 34397515
- DERIVEDLane JC, Craig R, Rees JL, Gardiner M, Mikhail MM, Riley N, Prieto-Alhambra D, Furniss D. Low rates of serious complications and further procedures following surgery for base of thumb osteoarthritis: analysis of a national cohort of 43 076 surgeries. BMJ Open. 2021 Jul 7;11(7):e045614. doi: 10.1136/bmjopen-2020-045614. PMID 34233971
- DERIVEDLane JCE, Craig RS, Rees JL, Gardiner MD, Shaw AV, Spiteri M, Kuo R, Dean BF, Green J, Prieto-Alhambra D, Furniss D. Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis. Rheumatology (Oxford). 2021 Sep 1;60(9):4262-4271. doi: 10.1093/rheumatology/keaa925. PMID 33410485
- DERIVEDLane JCE, Craig RS, Rees JL, Gardiner MD, Green J, Prieto-Alhambra D, Furniss D. Serious postoperative complications and reoperation after carpal tunnel decompression surgery in England: a nationwide cohort analysis. Lancet Rheumatol. 2020 Sep 30;3(1):e49-e57. doi: 10.1016/S2665-9913(20)30238-1. eCollection 2021 Jan. PMID 33381769
- DERIVEDCraig RS, Lane JCE, Carr AJ, Furniss D, Collins GS, Rees JL. Serious adverse events and lifetime risk of reoperation after elective shoulder replacement: population based cohort study using hospital episode statistics for England. BMJ. 2019 Feb 20;364:l298. doi: 10.1136/bmj.l298.