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Racial disparities in surgery for thumb carpometacarpal osteoarthritis
Claire A Donnelley1, Chris J Lee1, Stephanie V Kaszuba1
1Yale University, Department of Orthopaedic Surgery, New Haven, CT 06524, United States.
Hand Surgery & Rehabilitation
|June 2, 2026
Summary
Minority Medicare beneficiaries were significantly less likely to receive surgery for thumb carpometacarpal osteoarthritis compared to White patients. This disparity persisted regardless of age, sex, or health conditions, highlighting potential inequities in surgical care for this common condition.
Area of Science:
- Orthopedics
- Health Services Research
- Epidemiology
Background:
- Thumb carpometacarpal (CMC) osteoarthritis is a leading cause of upper extremity disability.
- Surgical management options include resection arthroplasty (RA) and prosthetic arthroplasty, with differing adoption rates globally.
- Understanding demographic disparities in surgical access is crucial for equitable care.
Purpose of the Study:
- To investigate the association between patient race and the likelihood of undergoing surgery for thumb CMC osteoarthritis.
- To examine surgical trends in the Medicare population preceding a shift in treatment strategies.
Main Methods:
- Retrospective cohort study using 2015-2016 Medicare Standard Analytic Files (SAF).
- Identified patients with CMC osteoarthritis via ICD codes and surgical procedures via CPT codes.
- Multivariable logistic regression analyzed the impact of race, age, sex, and Elixhauser Comorbidity Index (ECI) on surgical utilization.
Main Results:
- Of 108,512 beneficiaries, 41.3% had surgery.
- Surgical rates were higher in younger patients (≤64 years) and women.
- Adjusted odds of surgery were significantly lower for Black, Asian, Hispanic, and Native American patients compared to White patients (all p ≤ 0.001).
Conclusions:
- Racial minority groups were substantially less likely to undergo surgery for thumb CMC osteoarthritis than White patients.
- These disparities were independent of age, sex, and comorbidity.
- Findings underscore potential racial inequities in surgical treatment for thumb CMC osteoarthritis within the Medicare population.
