Article
Annual trends in surgery for osteoarthritis of carpometacarpal joint of the thumb: Analysis of a national database in Japan
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Authors
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Kosuke Uehara
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
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Yutaka Morizaki
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
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Takashi Ohe
- Department of Orthopaedic Surgery, NTT Medical Center Tokyo, Tokyo, Japan
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Nobuaki Michihata
- Department of Health Services Research, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Hideo Yasunaga
- Department of Clinical Epidemiology and Health Economics, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Sakae Tanaka
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| Published: | February 6, 2020 |
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Outline
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Objectives/Interrogation: There have been no reports to clarify annual trends in surgery for osteoarthritis (OA) of carpometacarpal (CMC) joint of the thumb. The aim of this study was to examine the annual numbers of surgeries related to the CMC joint of the thumb in Japan, using the Diagnosis Procedure Combination database, which is a nationally representative inpatient database of hospital information, discharge abstract, and administrative claims data, including about 55% of all acute-care inpatients in Japan.
Methods: For this study, we extracted data on a total of 2,210 patients who underwent arthroplasty (AP) (n=1,215) or arthrodesis (AD) (n=995) of the thumb CMC joint from July 2010 to March 2016. We examined patients' age, gender, accompanying bone graft, length of stay, total costs (in US dollars), year, and type of anesthesia.
Results and Conclusions: The average and standard deviation of age (years) in the AP and AD groups was 63.7 (10.4) and 63.7 (10.2) years, respectively. Males made up 17% and 31% of the AP and AD groups, respectively (P<0.001). Bone graft was accompanied in 12 (17%) patients in the AD group, and 398 (40%) patients in the AD group (P<0.001). The average length of stay was 11.5 days in the AP group and 10.9 days in the AD group (P<0.001). The average total cost was $5,760 in the AP group, and $6,090 in the AD group. The numbers of surgical patients each year in the AP/AD groups were 157/169, 242/200, 187/155, 221/186, and 264/202 in 2011, 2012, 2013, 2014 and 2015, respectively (P=0.023). General anesthesia was selected in 875 (72%) patients in the AP group, and 775 (79%) patients in the AD group (P=0002).The AP/AD group ratio gradually increased year by year together with the spread of surgical techniques of arthroplasty. The ROAD study, a large population-based cohort study, revealed that about 50% of all adults, both male and female, had OA of the CMC joint of the thumb on the X ray imaging. This figure was comparable to those in OA of the hip or the knee. However, our study showed that the annual numbers of surgery for OA of CMC joint of the thumb was much smaller than those for total knee replacement or total hip replacement in Japan. This may be because (i) there are fewer recommendable surgical procedures for OA of CMC joint of the thumb than for the knee or the hip, and (ii) pain derived from pinch motion can be less severe than that from gait or getting up.
