Reoperation and Readmission Rates in Rheumatoid Arthritis versus Osteoarthritis following Thumb Basal Joint Arthroplasty: A Retrospective Comparative Analysis
Zachary Demetriou, Kimberly Dong, Daniel Nemirov, RicK J TostiObjectives
Arthritis of the first carpometacarpal joint can often necessitate surgical intervention in the form of a thumb basal joint arthroplasty (BJA). Post-operative outcomes may be affected by the type of underlying arthritis, particularly rheumatoid arthritis (RA) vs. osteoarthritis (OA). To better inform shared decision-making, this study aimed to compare reoperation and readmission rates following thumb BJA surgery in RA vs. OA.
Methods
Cohorts were developed by retrospectively identifying patients with first carpometacarpal arthritis secondary to RA or OA who were treated with BJA using the TriNetX Research Database. Propensity score matching was implemented to adjust for preoperative risk differences. Cohorts were evaluated for primary outcomes of reoperation and readmission rates at 12 months. Measures of association, such as risk ratios and 95% confidence intervals, were used to compare RA against OA primary outcomes.
Results
After matching, 2,064 patients aged 65 to 90 years old were included. RA patients were significantly more likely to have reoperation by revision BJA at 12 months (RR = 2.3, P value 0.002). No significant difference was noted in reoperation rates due to implant removal between RA and OA (RR = 1.2, P value = 0.8). RA patients were significantly more likely to experience readmission at 12 months (RR = 1.5, P value 0.008). RA patients were also significantly more likely to experience systemic complications within 12 months, such as acute kidney failure, pneumonia, and urinary tract infection.
Conclusion
Following BJA, patients with RA have a higher incidence of reoperation at 12 months than those with OA. Patients with RA are more likely to experience readmission postoperatively as well as systemic complications. A deeper understanding of outcomes, such as reoperation rates, can help inform patient-physician shared decision-making.