van den Hurk Antonius A, Lauwers Thomas M A S, Spekenbrink-Spooren Anneke, Hommes Juliëtte E, van der Hulst René R W J, Schols Rutger M, Keuter Xavier H A
Department of Plastic, Reconstructive, and Hand Surgery, Maastricht University Medical Center+, Maastricht, The Netherlands.
Dutch Arthroplasty Register (LROI), 's-Hertogenbosch, The Netherlands.
JPRAS Open. 2025 Feb 6;44:49-57. doi: 10.1016/j.jpra.2025.02.004. eCollection 2025 Jun.
The treatment of carpal- and carpometacarpal arthritis using arthroplasty is becoming more common in hand surgery. Trapeziectomy is regarded as the standard treatment. Complications of trapeziectomy like thumb shortening and reduced mobility may be less common in arthroplasty. However, arthroplasty may cause implant failure and possible revision surgery. The Dutch arthroplasty registry (LROI) has been registering hand and wrist implants since 2016. Data from the LROI from 2017 to 2022 was used aiming to assess descriptive data regarding carpal- and carpometacarpal arthroplasty to demonstrate associations between arthroplasty and possible risk factors. Furthermore, this study aims to demonstrate the potential of the LROI and assess registration completeness. The registry included 178 primary first carpometacarpal arthroplasties, along with 23 revision arthroplasties. About 69.1 % of primary surgeries was performed by plastic surgeons, the others by orthopedic surgeons. Primary surgery was performed in women in 74.2 % of cases. Revision arthroplasty was performed as often by plastic surgeons, as by orthopedic surgeons. Too few carpal implants were registered to assess these types of implants. Comparing the registrations in the LROI with the national healthcare claims database showed a completeness of 9.04 % for plastic surgeons, and 30.39 % for orthopedic surgeons. This low registration completeness did not allow for any definitive conclusions to be drawn. However, this study shows large-scale registries may provide useful insights, possibly guiding clinical decision-making. To improve registration completeness, efforts should be made to facilitate registration as quick as possible, while also boosting awareness among physicians that perform carpal- and carpometacarpal arthroplasty.
在手外科中,使用关节成形术治疗腕关节和腕掌关节关节炎正变得越来越普遍。大多角骨切除术被视为标准治疗方法。在关节成形术中,大多角骨切除术的并发症如拇指缩短和活动度降低可能不太常见。然而,关节成形术可能导致植入物失败以及可能需要进行翻修手术。荷兰关节成形术登记处(LROI)自2016年以来一直在登记手部和腕部植入物。使用了LROI 2017年至2022年的数据,旨在评估有关腕关节和腕掌关节成形术的描述性数据,以证明关节成形术与可能的风险因素之间的关联。此外,本研究旨在展示LROI的潜力并评估登记的完整性。该登记处包括178例初次第一腕掌关节成形术以及23例翻修关节成形术。约69.1%的初次手术由整形外科医生进行,其他由骨科医生进行。74.2%的病例中初次手术是在女性中进行的。整形外科医生和骨科医生进行翻修关节成形术的频率相同。登记的腕关节植入物太少,无法评估这类植入物。将LROI中的登记情况与国家医疗保健索赔数据库进行比较,结果显示整形外科医生的登记完整性为9.04%,骨科医生为30.39%。如此低的登记完整性无法得出任何明确结论。然而,本研究表明大规模登记处可能提供有用的见解,可能会指导临床决策。为提高登记完整性,应努力尽快促进登记,同时提高进行腕关节和腕掌关节成形术的医生的意识。