Fano Adam N, Graham Jack G, Dang Jonathan, Kasper Alexis, Ilyas Asif M
Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, PA.
Drexel University College of Medicine, Philadelphia, PA.
J Hand Surg Glob Online. 2024 Feb 8;6(3):268-272. doi: 10.1016/j.jhsg.2023.12.013. eCollection 2024 May.
Thumb basal joint arthroplasty (BJA) performed for thumb basal joint arthritis is associated with high patient satisfaction. However, complications requiring reoperation occur, with a previously reported early reoperation rate (within 2 years) of 1.5%. The purpose of this study was to determine the risk of and reasons for reoperation in the intermediate term, defined as within 5 years of the index surgery.
All cases of primary thumb BJA performed from 2014 to 2016 at a single private academic center were reviewed. For cases requiring reoperation, data regarding index surgical technique, reason for reoperation, time to reoperation, and reoperation technique were collected. Risk of reoperation (return to the operating room for any reason) and risk of revision arthroplasty (revision surgery for symptomatic subsidence or instability) within 5 years of the index surgery were calculated.
A total of 686 primary thumb BJAs were performed in 637 patients. Risk of reoperation for any reason was 2.0% (14/686), and risk of revision arthroplasty for symptomatic subsidence or instability was 0.6% (4/686) within 5 years of surgery. The mean time between the index surgery and reoperation was 10.3 months (range, 16 days to 4.6 years) for all cases; however, for revision arthroplasty, the mean time was 9.6 months (range, 3.9-14.3 months).
The intermediate term (5 years minimum) rate of reoperation following thumb BJA for any reason was 2%, with only approximately one-fourth of reoperation cases requiring revision arthroplasty for symptomatic subsidence or instability. These data may provide useful information in the counseling of patients considering thumb BJA surgery.
TYPE OF STUDY/LEVEL OF EVIDENCE: Prognostic IV.
因拇指腕掌关节关节炎而行拇指腕掌关节置换术（BJA）的患者满意度较高。然而，仍会出现需要再次手术的并发症，此前报道的早期再手术率（2年内）为1.5%。本研究的目的是确定中期（定义为初次手术5年内）再次手术的风险及原因。
回顾了2014年至2016年在一家私立学术中心进行的所有原发性拇指BJA病例。对于需要再次手术的病例，收集了有关初次手术技术、再次手术原因、再次手术时间和再次手术技术的数据。计算了初次手术5年内再次手术（因任何原因返回手术室）和翻修关节成形术（因症状性下沉或不稳定而进行翻修手术）的风险。
637例患者共进行了686例原发性拇指BJA手术。手术5年内，因任何原因再次手术的风险为2.0%（14/686），因症状性下沉或不稳定而进行翻修关节成形术的风险为0.6%（4/686）。所有病例初次手术与再次手术之间的平均时间为10.3个月（范围为16天至4.6年）；然而，对于翻修关节成形术，平均时间为9.6个月（范围为3.9 - 14.3个月）。
拇指BJA术后中期（至少5年）因任何原因再次手术的发生率为2%，只有约四分之一的再次手术病例因症状性下沉或不稳定需要进行翻修关节成形术。这些数据可为考虑拇指BJA手术的患者提供有用的咨询信息。
研究类型/证据水平：预后IV级。
