MCID, SCB, and PASS Thresholds After Percutaneous Trigger Finger Release With or Without Corticosteroid Injection

Background/Objectives: Percutaneous A1 pulley release effectively treats trigger finger, but the additional benefit of concomitant corticosteroid injection remains debated. Moreover, minimal clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) thresholds have not been well established for this procedure, limiting patient-centered interpretation of outcomes. Methods: This retrospective cohort study included 80 patients (40 per group) who underwent percutaneous trigger finger release alone (PR) or with adjunctive triamcinolone injection (PR+CS). Anchor-based MCID and SCB thresholds for QuickDASH (Quick Disabilities of the Arm, Shoulder and Hand), Michigan Hand Outcomes Questionnaire (MHQ), and visual analog scale (VAS) pain were derived using GROC as the external anchor, whereas PASS thresholds were derived using a dichotomous acceptable-state question; ROC analysis was used for all threshold estimates. Group comparisons incorporated effect sizes and responder analyses. Results: MCID thresholds were ΔVAS ≥ 3, ΔQuickDASH ≥ 19, and ΔMHQ ≥ 16.5; SCB thresholds were ΔVAS ≥ 4, ΔQuickDASH ≥ 25, and ΔMHQ ≥ 20; and PASS thresholds were 3-month VAS ≤ 4, QuickDASH ≤ 29, and MHQ ≥ 76. For MCID and SCB, MHQ showed the highest observed AUCs (0.899 and 0.946, respectively). Greater mean improvements in all change scores were observed in the PR+CS group than in the PR group (ΔQuickDASH 24.2 vs. 19.9, p < 0.001, d = 1.39; ΔMHQ 20.5 vs. 15.0, p < 0.001, d = 1.67). However, the magnitudes of the between-group differences did not reach the derived MCID or SCB thresholds. PASS achievement was numerically higher in the PR+CS group than in the PR group (75% vs. 55%), but this difference did not reach statistical significance (p = 0.061). Conclusions: Preliminary MCID, SCB, and PASS estimates were derived for percutaneous trigger finger release; the principal novelty lies in the procedure-specific SCB and PASS estimates, with the SCB estimates being, to our knowledge, the first reported for any trigger finger treatment modality. MHQ showed the highest observed AUCs for MCID and SCB, whereas QuickDASH showed the highest observed AUC for PASS, underscoring the complementary information provided by the three instruments. Although greater mean functional changes were observed in the PR+CS group, the magnitudes of the between-group differences did not reach the derived MCID or SCB thresholds. However, given the retrospective, non-randomized design, these between-group findings remain exploratory and hypothesis-generating and should be viewed as a patient-centered re-interpretation of an established clinical question rather than as new comparative evidence; no causal benefit of adjunctive corticosteroid injection can be inferred. Given the small anchor-defined derivation subgroups and the potential instability of the selected cut-offs, these candidate estimates require prospective external validation in independent cohorts before clinical application.