A Changing Landscape in Surgical Treatment of Basilar Thumb Arthritis: Is the Rate of Denervation Increasing?

IF 2.1 2区 医学 Q2 ORTHOPEDICS
Daniel A Portney, Cody P Lee, Jennifer M Wolf, Jason A Strelzow, Jeffrey G Stepan
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引用次数: 0

Abstract

Purpose: The purpose of this study was to assess the evolving landscape of surgical interventions for basilar thumb arthritis.

Methods: Using a national insurance claims database spanning from 2016 to 2022, patients undergoing surgical treatment for thumb carpometacarpal (CMC) arthritis were identified through International Classification of Disease 10 and Current Procedural Terminology codes. The incidence of each type of surgical procedure was collected and normalized to the 2016 level. The total percentage change in incidence and linear regression trendline was calculated over the 7-year period. Multiple variable logistic regression assessed factors associated with thumb CMC denervation.

Results: Among 64,281 surgically treated patients, trapeziectomy with interposition arthroplasty was the most common (83.8%). Although thumb CMC denervation was the least common surgery and accounted for only 1.0% of all surgery, the incidence of denervation increased over the study period from 0.47 to 1.30 per 1,000,000, alongside a 41% rise in trapeziectomy alone. Regression analysis revealed male sex, Western US region, and concomitant carpal tunnel syndrome as associated factors for thumb CMC denervation.

Conclusions: The study indicates a notable shift in surgical approaches for basilar thumb arthritis. Although CMC denervation was the least commonly performed basal joint surgery, there was an increase in denervation procedures from 2016 to 2022. Denervation was not associated with patient age and was most strongly associated with male sex.

Type of study/level of evidence: Therapeutic IV.

改变拇指基底关节炎手术治疗的前景:去神经率是否在增加?
目的:本研究的目的是评估手术干预拇指基底关节炎的发展前景。方法:使用2016年至2022年的国家保险索赔数据库,通过国际疾病分类10和现行程序术语代码对接受手术治疗的拇指腕掌关节炎(CMC)患者进行鉴定。收集各类手术的发生率并归一化至2016年水平。计算了7年期间发病率的总百分比变化和线性回归趋势线。多变量logistic回归评估与拇指CMC去神经支配相关的因素。结果:在64281例手术治疗的患者中,梯形切除术合并间置关节置换术最常见(83.8%)。尽管拇指CMC去神经是最不常见的手术,仅占所有手术的1.0%,但在研究期间,去神经的发生率从0.47 / 1,000,000增加到1.30 / 1,000,000,而单是梯形切除术则增加了41%。回归分析显示男性、美国西部地区和伴随的腕管综合征是拇指CMC去神经支配的相关因素。结论:该研究提示了基底拇指关节炎手术入路的显著转变。虽然CMC去神经是最不常见的基底关节手术,但从2016年到2022年,去神经手术有所增加。去神经支配与患者年龄无关,与男性的相关性最强。研究类型/证据水平:治疗性IV。
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来源期刊
CiteScore
3.20
自引率
10.50%
发文量
402
审稿时长
12 weeks
期刊介绍: The Journal of Hand Surgery publishes original, peer-reviewed articles related to the pathophysiology, diagnosis, and treatment of diseases and conditions of the upper extremity; these include both clinical and basic science studies, along with case reports. Special features include Review Articles (including Current Concepts and The Hand Surgery Landscape), Reviews of Books and Media, and Letters to the Editor.
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