Registration of carpometacarpal arthroplasty in the Dutch arthroplasty register: Impacting factors and participation

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.