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Beyond Functional Outcomes: Patient-Reported Perioperative Experience After Implant Trapeziometacarpal Joint
Alice Mangeon1, Laurent Obert1, Daniel Lepage1
1Department of Orthopaedic, Trauma, Plastic and Reconstructive Surgery, Hand Trauma Unit (SOS Mains), SINERGIES Research Unit (UR 4662), University Marie and Louis Pasteur, Besançon University Hospital (CHU de Besançon), Besançon, France.
Purpose:
Thumb carpometacarpal osteoarthritis is a common condition in older adults and may severely impair hand function and quality of life. When conservative treatment fails, trapeziometacarpal arthroplasty is a widely accepted surgical option, with well-documented clinical and functional outcomes. However, the subjective perioperative experience of patients remains poorly explored, despite its growing importance in value-based health care.
Methods:
This retrospective, multicenter observational study included patients who underwent primary implant trapeziometacarpal arthroplasty between November 2007 and December 2023 in two tertiary centers. A self-administered questionnaire specifically designed to assess perioperative experience was sent to all eligible patients. Demographic data, radiographic characteristics, patient satisfaction, perioperative discomfort, postoperative pain resolution, and time to "forgetting the thumb" were analyzed descriptively.
Results:
A total of 119 prostheses in 95 patients were analyzed, corresponding to a 42.6% response rate (95/223 eligible patients), with a mean follow-up of 6.4 ± 4.7 years. Overall satisfaction was high, with 83.2% of patients reporting being satisfied or very satisfied. Locoregional anesthesia was identified as the most unpleasant perioperative element by 22.7% of patients. Postoperative pain resolved rapidly in most cases, and 33.7% of patients reported "forgetting their thumb" within 4 months after surgery. Despite postoperative pain being frequently cited as unpleasant, only 2.5% of patients expressed a desire for improved analgesic protocols.
Conclusions:
Trapeziometacarpal arthroplasty is associated with high patient satisfaction and rapid perceived recovery. Beyond functional outcomes, perioperative experience particularly anesthesia-related discomfort and preoperative information plays a critical role in patient satisfaction. Integrating patient-reported experience into outcome assessment may help optimize perioperative care pathways.
Type Of Study/Level Of Evidence:
Prognosis IV.
