Thumb Carpometacarpal Arthritis Surgery: The Patient Experience

Abstract

steoarthritis of the thumb carpometacarpal, or basilar, joint is nearly universal as people age and can be debilitating or asymptomatic. 1,2 When patients do not adequately respond to nonoperative measures, a variety of surgical procedures are available and are mostly efficacious. No procedure is superior, with no notable differences between them other than perhaps cost and complications. [3][4][5][6][7][8][9][10][11] Still, there is a definite subset of patients, up to at least 15 percent, who are dissatisfied with some aspects of their surgical result regardless of the techniques

“Use of Treatments After Recovering from Thumb Carpometacarpal Arthritis Surgery

“…Although patients are usually reported to do well following thumb carpometacarpal surgery, 1,15,16 our findings support recent evidence that outcomes may be more variable than traditionally anticipated. 4,[17][18][19] This also indicates that, for a substantial number of patients, there are likely important factors that thumb carpometacarpal surgery does not address, Fig. 2.…”

“…10,11,26,27 Although taken together, our PROs are not unfavorable, having a relevant number of patients with unfavorable outcomes and continued treatments after surgery underscores the possibility of unmet expectations or dissatisfaction with the surgery itself. 4,17,19 Tracking such experiences is of paramount importance and remains a challenge because of the lack of effective long-term reporting following surgery. Therefore, carefully identifying expectations and underlying psychosocial factors preoperatively and early in the postsurgical course may facilitate improved patient-surgeon communication and, ultimately, results.…”

“…Although patients are usually reported to do well following thumb carpometacarpal surgery, 1,15,16 our findings support recent evidence that outcomes may be more variable than traditionally anticipated. 4,17–19 This also indicates that, for a substantial number of patients, there are likely important factors that thumb carpometacarpal surgery does not address, such as coping abilities and other psychosocial aspects. 20–23 Moreover, many other patient-specific factors not included in this study, and that we have listed as study limitations, may be associated with a likelihood for continued treatments after thumb carpometacarpal arthritis surgery.…”

“…2,3 Whereas a majority of patients improve with surgery, a substantial percentage continue to have difficulties postoperatively. 1,[4][5][6][7][8] There is an important knowledge gap for how often patients continue to use nonsurgical treatments after recovering from surgery. Exploring this issue is critical because it carries implications on the utility and success of surgery and could affect preoperative discussions.We had three aims for this study: first, to determine what treatments our patients continued to use after recovering from primary thumb carpometacarpal arthritis surgery; second, to assess whether patients using such treatments returned to the same ones they used before surgery; and third, to evaluate whether patients who continued to use treatments had significantly different patient-reported outcomes (PROs) compared with those who did not.…”

“…2,3 Whereas a majority of patients improve with surgery, a substantial percentage continue to have difficulties postoperatively. 1,[4][5][6][7][8] There is an important knowledge gap for how often patients continue to use nonsurgical treatments after recovering from surgery. Exploring this issue is critical because it carries implications on the utility and success of surgery and could affect preoperative discussions.…”