Product Description

Using the IBM MarketScan Outpatient Services and Pharmaceutical Claims databases (2012–2016), this study compared outcomes after thumb carpometacarpal (CMC) arthroplasty alone versus CMC arthroplasty performed concurrently with carpal tunnel release (CTR) and/or trigger finger release (TFR) to determine whether bundling procedures increases postoperative risk. The cohort included 18,010 CMC-only patients and 4,064 patients undergoing multiple procedures (most commonly CMC + CTR), and outcomes assessed were persistent opioid use (60–180 days post-op), 30-day readmissions (ED visits), 30-day complications (wound disruption/infection), and CRPS within 1 year. Compared with the multiple-procedure group, CMC-only patients had lower persistent opioid use (16% vs 18%) and lower 30-day readmissions (3% vs 4%), with decreased adjusted odds of both outcomes; pain was the most common reason for readmission. The authors conclude that adding CTR and/or TFR to CMC arthroplasty slightly increases the odds of adverse outcomes such as persistent opioid use and readmission, and surgeons and patients should weigh the convenience of a single operative setting against these incremental risks.

Intended Audience

This educational activity is intended for all CME-related persons including plastic surgery practitioners, residents, and other healthcare professionals.

Learning Objectives

After viewing this course, the participant should be able to:

1. Describe the clinical rationale for and prevalence of performing concurrent procedures (carpal tunnel release and/or trigger finger release) at the time of thumb CMC arthroplasty, including how often these combinations occurred in the study cohort.
2. Explain the study design and methodology used to compare CMC-only versus combined-procedure cases, including the database used, inclusion criteria, outcome definitions (persistent opioid use, 30-day readmissions, 30-day complications, CRPS), and key covariates used for adjustment.
3. Interpret the primary findings regarding the association between adding carpal tunnel and/or trigger finger release to CMC arthroplasty and (a) persistent opioid use and (b) 30-day readmissions, including the magnitude and direction of differences reported.
4. Identify and contextualize postoperative drivers of unplanned care by summarizing the most common reasons for 30-day readmissions following these procedures, with emphasis on pain-related presentations.
5. Apply the paper’s conclusions to shared decision-making, weighing the efficiency of single-setting, multi-procedure surgery against the observed incremental risks (e.g., persistent opioid use and readmissions), and recognizing the study’s limitations and implications for patient selection and counseling.

Faculty:

Trinh, Pavin BS; Luan, Anna MD; Tawfik, Vivianne L. MD, PhD; Sheckter, Clifford MD; Rochlin, Danielle MD; Fox, Paige MD, PhD; Curtin, Catherine MD

Plastic and Reconstructive Surgery Editors

Editor-in-Chief: Kevin C. Chung, MD

Co-editor: Amy S. Colwell, MD

CME Faculty:

Nicole J. Jarrett, MD, FACS

Jacquelynn T. Lee, MD

Accreditation

The American Society of Plastic Surgeons (ASPS) is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.

Designation

The ASPS designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

AMA PRA Category 1 CreditTM: 1.0

Media: Journal Article

Release Date: 3/31/2026

Expiration Date: 3/31/2029*

Estimated time to complete this course: 1 hour

*Course access ends on course expiration date

Disclosure Policy

The American Society of Plastic Surgeons (ASPS) requires all instructors, planners, reviewers, managers and other individuals in a position to control or influence the content of an activity to disclose all relevant financial relationships or affiliations. All identified conflicts of interest must be resolved and the educational content thoroughly vetted by ASPS for fair balance, scientific objectivity and appropriateness of patient care recommendations. ASPS also requires faculty/authors to disclose when off-label/unapproved uses of product are discussed in a CME activity or included in related materials.

Disclaimer: All relevant financial relationships for planners, faculty and others in control of content (either individually or as a group) are reviewed by the ASPS Continuing Education Committee and have been mitigated, if applicable.

The following planners and faculty members have no relevant financial relationships or affiliations to disclose:

Catherine Curtin, MD

Paige Fox, MD, PhD

Nicole J. Jarrett, MD, FACS

Jacquelynn T. Lee, MD

Anna Luan, MD

Danielle Rochlin, MD

Clifford Sheckter, MD

Vivianne L. Tawfik, MD, PhD

Pavin Trinh, BS

Recognition Statement

The Continuing Medical Education (CME) credits offered by this activity are enhanced by ASPS Learner Credit Reporting for learners who have opted into this reporting. Successful completion of this CME activity enables active American Board of Surgery (ABS) members the opportunity to earn credit toward the CME requirement of the ABS's Continuous Certification program when claimed within 30 days of completion of the activity.

Directly provided by the American Society of Plastic Surgeons® (ASPS®)

Participants in ASPS-accredited education who want their CME credits reported to certifying and state licensing boards must opt-in to reporting and add their NPI as well as state license ID and/or collaborating board ID(s) before claiming credit.

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