Variation in Technique Influences Surgical Cost in Thumb Carpometacarpal Joint Arthroplasty.

Background: Thumb carpometacarpal (CMC) arthritis is common in the community. There are a variety of ways to perform CMC arthroplasty with the basic technique revolving around trapeziectomy. The purpose of this study was to identify key factors in the determination of cost of CMC arthroplasty and if procedure type affects cost.

Materials and methods: Patients from 2018 to 2022 from a single health care system who received primary CMC arthroplasty using ligament reconstruction tendon interposition (LRTI), simple suture suspensionplasty, or suture tape-based reconstruction techniques were identified. Surgical costs were determined using time-driven activity-based cost accounting.

Results: A total of 173 patients were included. The average age was 63.6 years and 70.5% (n=122) were women. The most common technique was suture suspensionplasty (n=142, 82.1%). The average surgical cost was $2,830.36±$619.41. Suture suspensionplasty had the shortest operative time, followed by LRTI, and lastly suture tape-based reconstruction (62.9±16.0, 70.7±19.6 and 102.7±16.6 minutes, respectively, P<0.001). Procedure type and anchor use predicted surgical costs (R²=0.85, P<0.001).

Conclusion: Suture suspensionplasty had the shortest operative time and had the lowest cost of CMC arthroplasty techniques. The use of an anchor was associated with increased cost. Surgeons should keep these cost drivers in mind as they develop treatment plans. Surgeons and organizations should collaborate to provide high-value and economically-responsible care. [Orthopedics. 2025;48(4):e177-e181.].