Background: Thumb carpometacarpal joint osteoarthritis (CMCJ OA) is a common degenerative condition that causes pain, stiffness, and disability, reducing quality of life. Surgery is a well-established treatment option when conservative management fails, but the optimal surgical approach remains debated. This study compared the cost-utility of trapeziectomy with ligament reconstruction and tendon interposition (LRTI + T) versus suture suspension arthroplasty (SSA) for CMCJ OA. Methods: A Markov microsimulation model was developed to compare LRTI + T and SSA from a hospital payer perspective. Outcomes included incremental cost-effectiveness ratio, quality-adjusted life years (QALYs), total cost, and net monetary benefit. Clinical outcomes such as complication rates and revision surgery were also evaluated. Results: LRTI + T had a higher complication rate (14. 6%) than SSA (9. 8%), but SSA had a slightly higher revision rate (7. 1% versus 5. 7%). Over a lifetime, SSA provided an incremental gain of 0. 25 QALYs but was marginally more expensive (2855 versus 2842). SSA yielded an incremental cost-effectiveness ratio of 53. 80 per QALY, making it the more cost-effective strategy. Conclusions: SSA is a cost-effective alternative to LRTI + T, offering valuable insights for clinicians and policymakers optimizing care for CMCJ OA patients.
Wong et al. (Wed,) studied this question.
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