Longitudinal management trends of basilar thumb arthritis: A national epidemiologic analysis.

Purpose: Osteoarthritis (OA) of the first carpometacarpal (CMC) joint, or basilar thumb arthritis, is the most common symptomatic hand arthritis, leading to significant healthcare costs. This study analyzed trends in managing basilar thumb arthritis and determined approaches linked to favorable outcomes to guide future treatments.

Methods: This retrospective cohort study queried the TriNetX United States Collaborative Network from 2013 to 2023. Patients with primary OA of the first CMC joint were identified using International Classification of Diseases-10 codes, and surgical interventions were classified using Current Procedural Terminology codes. Patients were stratified by surgical status and age groups (18-59 years and 60 years or older). Baseline demographic characteristics, risk factors, and mortality rates were compared between surgical and non-surgical cohorts. The incidence and prevalence of surgical interventions for basilar thumb arthritis were also determined.

Results: The study included 213,881 patients with primary basilar thumb arthritis (12,923 in the operative group and 195,820 in the non-operative cohort). Obesity (BMI 30-39), nicotine dependence, and Type 2 diabetes mellitus were more prevalent in the operative group (p < 0.01). The non-operative cohort had a lower average BMI (20-29, p = 0.04). Surgery incidence rose from 0.13 % in 2013 to 1.13 % by 2023, while prevalence increased from 0.45 % to 5.93 %. The matched odds ratios were 0.652 for 1-year, 0.763 for 3-year, and 0.818 for 5-year mortality.

Conclusions: Management of basilar thumb arthritis is shifting towards more surgical interventions. Identifying optimal patient profiles for surgery will refine management strategies for this condition.