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Predicting Contralateral Surgery for Trapeziometacarpal Arthrosis Within 5 Years
Kevin Kooi1, Varun Nukala2, Nienke A F Smits3
1Department of Orthopaedic Surgery, Hand and Arm Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Department of Plastic, Reconstructive, and Hand Surgery, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands; Musculoskeletal Health Program, Amsterdam Movement Sciences, Amsterdam, the Netherlands.
About 21% of patients with trapeziometacarpal (TMC) joint arthritis surgery later undergo contralateral surgery. Younger age, bilateral thumb pain, and anxiety predict the need for further TMC surgery.
Area of Science:
- Hand surgery
- Orthopedic surgery
- Rheumatology
Background:
- Trapeziometacarpal (TMC) joint arthritis is a frequent cause of hand pain.
- The rate of contralateral surgery for TMC arthritis is not well-established.
- Understanding predictors for bilateral surgery is crucial for patient management.
Purpose of the Study:
- To determine the frequency of contralateral TMC surgery after initial surgery.
- To identify predictive factors for contralateral TMC surgery.
Main Methods:
- A retrospective study of 712 patients who underwent primary TMC surgery.
- Data collection included demographics, surgical details, and follow-up information over 5 years.
- Multivariable logistic regression and random forest models were used to predict contralateral surgery.
Main Results:
- 21% of patients (153/712) had contralateral TMC surgery within 5 years.
- Younger age (OR=0.95), bilateral thumb pain (OR=3.76), and anxiety disorders (OR=1.84) were significant predictors.
- 32% of patients initially presented with bilateral thumb pain.
Conclusions:
- The rate of contralateral TMC surgery is 21% in patients who have undergone prior surgery.
- Younger patients, those with bilateral thumb pain, and those with anxiety disorders are more likely to require contralateral surgery.
- These factors can aid in surgical planning and patient counseling.
