Characteristics of Patients undergoing Distal Radioulnar Joint Arthroplasty: A National Database Review
Suresh K Nayar, MD, Johns Hopkins University, Baltimore, MD, Brian Sullivan, M.D., Johns Hopkins Department of Orthopaedic Surgery, Baltimore, MD and Keith T Aziz, MD, University of Cincinnati, Cincinnati, OH
Background: The distal radioulnar joint (DRUJ) plays a significant role in forearm rotation, and is critical for normal force transmission across the hand and forearm. DRUJ pathology can be treated with several different procedures, but in cases where there is symptomatic arthritis DRUJ arthroplasty has emerged as an excellent surgical option. While some studies suggest low complication rates, they are based on limited number of patients and many were from the same institution. The purpose of this study is to utilize a nationwide database to identify patient characteristics of those undergoing DRUJ arthroplasty and to describe the perioperative complication profile of patients undergoing DRUJ arthroplasty.
Methods: The ACS-NSQIP database was queried to identify patients undergoing DRUJ arthroplasty between 2006-2018. Patients were identified by current Procedural Terminology (CPT) code. Demographics, co-morbidities, American Society for Anesthesiologists (ASA) classification, and preoperative laboratory values were identified and descriptive statistics were used to characterize the profile of patients undergoing DRUJ arthroplasty.
Results: A total of 38 patients were identified to have undergone DRUJ arthroplasty, with a trend towards increasing utilization of DRUJ arthroplasty. Patients on average were 54.8 (+ 2.5 ) years old, were more likely to be female (63.2%), and were overwhelmingly treated in the outpatient setting (78.9%). The most common co-morbid conditions included hypertension (44.7%), diabetes (13.2%), and history of smoking (13.2%). The average ASA score was 2.2, and most patients had surgery under general anesthesia (60.5%). No re-operations, readmissions, or complications were identified in the 30 day postoperative period.
Conclusion: DRUJ arthroplasty is a safe procedure, and has acceptably low complication rates in the acute post-operative period. There has recently been an increase in the utilization of DRUJ arthroplasty.
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