Trends in Thumb Carpometacarpal Arthroplasty: A Decade in Review.

Background: Carpometacarpal (CMC) arthroplasty can provide symptomatic relief and improvement in function in patients with CMC osteoarthritis. The study purpose was to identify demographic, 30-day outcome, and reimbursement trends in CMC arthroplasty between 2012 and 2021.

Methods: This was a retrospective cohort study of adult patients undergoing CMC arthroplasty from January 1, 2012, to December 31, 2021, using the National Surgical Quality Improvement Program database. Patients were stratified based on year of index surgery: 2012-2015, 2016-2018, and 2019-2021. Baseline characteristics were collected and compared using the appropriate statistical test. Multivariable logistic regressions controlling for age and sex were performed to identify independent risk factors for 30-day morbidity, readmissions, and reoperations. Economic analyses assessed changes in reimbursement rates over the span of 10 years.

Results: A total of 9046 patients were included in the analysis with mean age of 62.7 ± 9.2 and women comprising 74.9% of the total population. Between 2012 and 2021, the annual volume increased from 433 to 1043. The average body mass index (BMI) and proportion of patients with congestive heart failure (CHF) increased in 2019-2021. Increasing age, BMI, smoking, and length of stay ≥ 1 day were independent risk factors for 30-day readmissions. The Medicare reimbursement fee decreased by an average of 1.15% annually, for a total of 9.90% across 10 years.

Conclusions: The volume of CMC arthroplasty has risen from 2012 to 2021. However, conditions such as obesity and CHF have become more prevalent. Despite the growing patient complexity, Medicare reimbursement fees have markedly decreased.