SO25. Predictors and Utilization of Thumb Carpometacarpal Joint Denervation for Osteoarthritis

PURPOSE: Thumb carpometacarpal (CMC) osteoarthritis is a common condition that may occur due to age-related degenerative changes or trauma. The current study analyzed a national database to identify trends in CMC denervation and factors associated with undergoing denervation to treat thumb CMC osteoarthritis. METHODS: Patients who underwent arthroplasty, trapezium excision, ligament reconstruction with or without tendon interposition, and denervation with a history of thumb CMC arthritis were identified in the PearlDiver Mariner165 database from 2015 to 2021. The use of occupational therapy, orthosis, and corticosteroid injection were analyzed in the database. Demographic and clinical characteristics associated with undergoing denervation compared to another surgical intervention were assessed. RESULTS: A total of 67,539 patients with a history of thumb CMC osteoarthritis underwent surgery between 2015 and 2022. Of these, denervation was the treatment for 901 patients (1.3%). Denervation was associated with a history of bracing (OR: 4.21) and therapy management (OR: 1.90) but less likely if there was a history of a single (OR: 0.72) or multiple (OR: 0.37) steroid injections. Total cost for denervation was significantly less than other surgeries ($958 vs $1,237). Preoperative therapy and corticosteroid injections were associated with decreased time-to-therapy. Finally, the use of denervation increased significantly (fewer than 11 patients) in 2015 to approximately 2.2% (n=204) overall in 2021. CONCLUSION: Denervation is an increasingly popular intervention for symptomatic thumb CMC arthritis. This study utilized a national database to quantify the frequency of this procedure over time as well as identify factors associated with undergoing denervation.