• Daniel Donato, Abdullah M Abunimer, Hussam Abou-Al-Shaar, James Willcockson, Leah Frazer, and Mark A Mahan.
• Division of Plastic Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, USA.
• World Neurosurg. 2019 Feb 1; 122: e1374-e1380.

BackgroundFirst carpometacarpal (CMC) joint osteoarthritis (OA) is commonly encountered in clinical practice. The preferred surgical option when conservative therapy fails varies with the stage and nature of the disease. Denervation of the first CMC joint is a relatively new procedure for managing stable thumb CMC joint OA. Our objective was to review our experience and surgical technique with first CMC joint denervation surgery.MethodsAll patients who underwent first CMC joint denervation surgery from January 2015 through September 2017 were retrospectively identified. Before undergoing surgical CMC denervation, patients received a joint block at the first CMC joint with 0.25% bupivacaine. Only patients with a good response to injection were selected for surgical denervation. Patient demographics, preoperative and postoperative pain scores using a numeric rating scale, and grip strength using the Jamar Hydraulic Hand Dynamometer were analyzed.ResultsOf 10 patients (13 hands) with CMC joint OA, 8 patients (11 hands) met the inclusion criteria. Patients' average grip strength improved significantly after the procedure (from 38.4 ± 26.7 foot/lb to 50.2 ± 27.6 foot/lb; P = 0.007). The numeric rating scale pain score improved significantly from 7.8 ± 2.4 to 2.4 ± 1.8 (P < 0.001). Seven of 8 patients reported satisfaction with surgery. There were 2 complications.ConclusionsFirst CMC joint denervation provided good pain relief and improvement in grip strength in patients with thumb CMC joint OA. This minimally invasive technique proved to be a good option for providing optimal pain control and improvement in strength with minimal and mild complications.Copyright © 2018 Elsevier Inc. All rights reserved.

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