{
  "abstract": "Purpose\n\nSelective first carpometacarpal (CMC) denervation has gained interest as an alternative to trapeziectomy-based procedures for thumb CMC arthritis, with potential advantages including less soft tissue disruption, faster recovery, and preservation of future trapeziectomy as an option. However, cost-effectiveness data remain limited. We aimed to evaluate the 5-year cost-utility of selective first CMC denervation compared with trapeziectomy and continued nonsurgical management.Methods\n\nA hybrid decision-analysis and Markov model was developed for a hypothetical patient with first CMC arthritis who remained symptomatic after 6 months of nonsurgical management. Three strategies were compared over a 5-year horizon: continued nonsurgical management, selective first CMC denervation, and trapeziectomy. Model inputs were derived from a literature review. Costs were modeled from a Medicare Hospital Outpatient Department perspective and discounted at 3% annually. Monte Carlo microsimulation of 1,000 hypothetical patients estimated costs, quality-adjusted life years (QALYs), incremental net monetary benefit, and cost-utility at a willingness-to-pay threshold of $50,000/QALY. Deterministic sensitivity analyses assessed model robustness.Results\n\nDenervation had lower mean 5-year cost than trapeziectomy ($2,706.39 vs $4,276.96) and slightly greater effectiveness (3.87 vs 3.82 QALYs). Compared with trapeziectomy, denervation saved $1,580.46 and gained 0.06 QALYs (95% CI, 0.05-0.06), with a mean incremental net monetary benefit of $4,384.25. Denervation was preferred in 97.4% of simulations and remained cost-effective across all deterministic sensitivity analyses.Conclusions\n\nSelective first CMC denervation was less costly and more effective than trapeziectomy, supporting its cost-effectiveness for persistent first CMC arthritis after failed nonsurgical treatment.Level of evidence\n\nLevel II economic.Clinical relevance\n\nSelective first CMC denervation may be offered as a cost-effective surgical option for patients with persistent symptomatic thumb CMC arthritis, providing comparable clinical outcomes to trapeziectomy at lower cost while preserving future reconstructive alternatives.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Orthopaedic Surgery, University of Rochester School of Medicine, Rochester, NY."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 5,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Christopher M Dussik",
      "orcid": "0000-0003-3352-3708"
    },
    {
      "affs": [
        0
      ],
      "name": "Carlos Ortiz-Babilonia"
    },
    {
      "affs": [
        0
      ],
      "name": "Amy Phan"
    },
    {
      "affs": [
        0
      ],
      "name": "Daniel Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Joseph Ferraro"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/b7exefnsx74p8.bib",
  "cited_by": 0,
  "doi": "10.1016/j.jhsg.2026.101164",
  "fulltext_url": "https://europepmc.org/articles/PMC13679291",
  "id": "b7exefnsx74p8",
  "issns": [
    "2589-5141"
  ],
  "landing_url": "https://europepmc.org/article/MED/42899137",
  "language": "eng",
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2746|Orthopedic Surgery and Rehabilitation"
    ]
  ],
  "openalex": "W7221536876",
  "pdf_url": "https://europepmc.org/articles/PMC13679291?pdf=render",
  "pmcid": "PMC13679291",
  "pmid": "42899137",
  "published": "2026-10-12",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/b7exefnsx74p8.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:33Z",
      "native_id": "MED:42899137",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42899137"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2746|Orthopedic Surgery and Rehabilitation",
      "subfield": "surgery"
    }
  ],
  "title": "Selective First Carpometacarpal Denervation Is Cost-Effective Compared With Trapeziectomy for Thumb Carpometacarpal Arthritis.",
  "title_text": "Selective First Carpometacarpal Denervation Is Cost-Effective Compared With Trapeziectomy for Thumb Carpometacarpal Arthritis.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:33Z",
  "url": "https://research.draconitic.com/paper/b7exefnsx74p8",
  "venue": "Journal of hand surgery global online",
  "versions": []
}