Understanding early reoperation rates following thumb basal joint arthroplasty

The thumb carpometacarpal (CMC) joint is one of the most common sites for osteoarthritis. It is often treated with basal joint arthroplasty (BJA), a procedure known for high patient satisfaction. Despite this, early reoperations following BJA still occur and remain poorly understood. To address this gap, the TriNetX database was used to gain better insights into the frequency and underlying circumstances around early reoperations to better inform patients and surgeons. The study hypothesis was that the rate of reoperation following BJA surgery is low.

This is a retrospective cohort study analyzing patient data from 2017 to 2023 on TriNetX Research Network. Query initially included patients with unilateral thumb CMC arthritis who underwent index thumb BJA and further refined to include early reoperation. This was defined as any patient who had at least one relevant reoperation within 2 years of the index surgery. Demographics and clinical characteristics were compared; statistical analysis with Z-Test was performed to assess significant differences over the study period.

A query for patients with an index thumb BJA surgery performed during the study period returned 9853 patients. There was a total of 757 patients having at least one documented additional surgery within 2 years of the index BJA, yielding a reoperation rate of 8 %. Among these reoperations, 63 % were deemed to involve a revision or reconstructive procedure indicating failure of the index BJA, while the remaining 37 % represented accessory surgeries such as cyst excision and tenosynovectomies which may not directly be related to the index BJA. The reoperation group was older and had a higher rate of obesity (P < 0.05).

Early reoperation rates following thumb BJA is approximately 8 % at 2 years postoperatively, with approximately 5 % representing potentially a failure requiring revision of the index surgery. Increasing age and obesity were risk factors for reoperation. Technique-specific reoperation cannot be determined by this study.