Surgeon Preference, Influence, and Treatment of Thumb Carpometacarpal Arthritis

Deutch, Zachary; Niedermeier, Steven R.; Awan, Hisham M.

doi:10.1177/1558944717717506

Cited by 49 publications

(45 citation statements)

References 20 publications

(23 reference statements)

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“…This European-wide survey shows that at present, trapeziectomy with LRTI is the most popular primary surgical treatment for isolated CMC-1 OA among participating hand surgeons in Europe, chosen by 46% as a preferred surgical treatment. In the USA, trapeziectomy with LRTI is also the most popular procedure, with percentages of surgeons choosing this technique as their favorite varying between 55.7% and 67.6% [4][5][6]. However, it seems that in the past decade, this procedure has become less popular with percentages dropping from 67.6% in a survey of 2010, to 55.7% in a survey of 2017.…”

Section: Discussionmentioning

confidence: 99%

“…In the meanwhile, trapeziectomy with suspensionplasty, either with suture (12.4%) or with APL (15.4%), gained popularity [5]. Trapeziectomy without any complementary procedures was chosen by 21% of the respondents in our survey as being part of their preferred surgical treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Trapeziectomy without any complementary procedures was chosen by 21% of the respondents in our survey as being part of their preferred surgical treatment. In the USA, this procedure was chosen by only 8% of the respondents as their preferred surgical procedure [4][5][6]. Even though studies have shown that trapeziectomy only is associated with fewer complications compared to trapeziectomy with additional LRTI [2,3], the most recent US survey reported that only 15% of the respondents changed to trapeziectomy alone, from 24% of all surgeons that have changed procedures in the last 5 years [5].…”

Section: Discussionmentioning

confidence: 99%

“…It would be interesting to understand the varieties between the choices of surgeons in different countries. One study suggested that surgeons outside the USA rely more on current evidence, compared to surgeons in the USA [5]. A given reason was that less US hand surgeons work in an academic hospital setting, while this percentage would be higher in many international countries as a result of universal health care.…”

Section: Discussionmentioning

confidence: 99%

“…Current surgical practice patterns in operative treatment of carpometacarpal (CMC-1) osteoarthritis (OA) have been evaluated in the USA repeatedly [4][5][6]. Yet, the surgical practice among European hand surgeons remains unknown.…”

Section: Introductionmentioning

confidence: 99%

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Current trends in operative treatment of carpometacarpal osteoarthritis: a survey of European hand surgeons

2019

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Background Surgical practice patterns in operative treatment of carpometacarpal (CMC-1) osteoarthritis (OA) have been evaluated in the USA repeatedly. This study evaluates the current surgical patterns in the treatment of isolated CMC-1 OA among hand surgeons in Europe. Methods An online survey was distributed to hand surgeons of participating member states of the Federation of European Societies for Surgery of the Hand (FESSH). Information regarding country of practice, years of experience and surgical treatment of choice was collected. Statistical analyses of correlations between demographics and treatment preferences were done using chi-squared testing. Results A total of 444 replies were recorded. Trapeziectomy with ligament reconstruction and tendon interposition (LRTI) was opted by 46% of the respondents as a procedure of first choice, followed by prosthetic joint replacement (25%) and trapeziectomy with interpositional arthroplasty (23%). Among surgeons practicing in the Netherlands, 35% mentioned trapeziectomy without any complementary procedures as a surgical treatment of first choice. Prosthetic joint replacement is chosen by respectively 96% and 72% of the respondents in Belgium and France as a preferred surgical procedure. Conclusions This European-wide study provides insight in the prevailing surgical management for isolated CMC-1 OA. Trapeziectomy with LRTI is the most popular procedure among the participating hand surgeons in Europe. Geographical trends seem to play an important role in the choice of preferred technique. Factors influencing the decision-making among surgeons practicing in different countries should be explored more closely in future studies. Level of evidence Level IV, prognostic study.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current trends in operative treatment of carpometacarpal osteoarthritis: a survey of European hand surgeons

2019

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Radial Wrist Denervation

Dellon

2019

Joint Denervation

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Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis

Raj

Clay

Ramji

et al. 2021

Eur J Orthop Surg Traumatol

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Purpose This systematic review and meta-analysis directly compares joint replacement (JR) and trapeziectomy techniques to provide an update as to which surgical intervention is superior for first carpometacarpal (CMC-1) joint osteoarthritis. Methods In August 2020, MEDLINE, Embase and Web of Science were searched for eligible studies that compared these two techniques for the treatment of CMC-1 joint osteoarthritis (PROSPERO registration ID: CRD42020189728). Primary outcomes included the Disabilities of the Arm, Shoulder and Hand (DASH), QuickDASH (QDASH) and pain visual analogue scale (VAS) scores. Secondary outcomes, such as total complication, dislocation and revision surgery rates, were also measured. Results From 1909 studies identified, 14 studies (1005 patients) were eligible. Our meta-analysis found that post-operative QDASH scores were lower for patients in the JR group (five studies, p = 0.0004). Similarly, significantly better postoperative key pinch strength in favour of JR was noted (three studies, p = 0.001). However, pain (VAS) scores were similar between the two groups (five studies, p = 0.21). Moreover, JR techniques had significantly greater odds of overall complications (12 studies; OR 2.12; 95% CI 1.13–3.96, p = 0.02) and significantly greater odds of revision surgery (9 studies; OR 5.14; 95% CI 2.06–12.81, p = 0.0004). Conclusion Overall, based on very low- to moderate-quality evidence, JR treatments may result in better function with less disability with comparable pain (VAS) scores; however, JR has greater odds of complications and greater odds of requiring revision surgery. More robust RCTs that compare JR and TRAP with standardised outcome measures and long-term follow-up would add to the overall quality of evidence.

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Surgeon Preference, Influence, and Treatment of Thumb Carpometacarpal Arthritis

Cited by 49 publications

References 20 publications

Current trends in operative treatment of carpometacarpal osteoarthritis: a survey of European hand surgeons

Current trends in operative treatment of carpometacarpal osteoarthritis: a survey of European hand surgeons

Radial Wrist Denervation

Trapeziectomy versus joint replacement for first carpometacarpal (CMC 1) joint osteoarthritis: a systematic review and meta-analysis

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