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Letter Regarding “Risk of Infection in Thumb Carpometacarpal Surgery After Corticosteroid Injection”

      We read with interest the article by Qin et al,
      • Qin M.M.
      • Qin C.D.
      • Johnson D.J.
      • Kalainov D.M.
      Risk of infection in thumb carpometacarpal surgery after corticosteroid injection.
      which described 5,046 patients with base-of-thumb osteoarthritis identified in the Humana database using the PearlDiver platform. We noted several similarities, yet striking differences, related to our two 19-year longitudinal cohorts of individual patient data within the National Health Service, accounting for all secondary care, publicly remunerated activities in England.
      • Lane J.C.
      • Craig R.S.
      • Rees J.L.
      • et al.
      Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis.
      ,
      • Lane J.C.
      • Craig R.
      • Rees J.L.
      • et al.
      Low rates of serious complications and further procedures following surgery for base of thumb osteoarthritis: analysis of a national cohort of 43 076 surgeries.
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      References

        • Qin M.M.
        • Qin C.D.
        • Johnson D.J.
        • Kalainov D.M.
        Risk of infection in thumb carpometacarpal surgery after corticosteroid injection.
        J Hand Surg Am. 2021; 46: 765-771
        • Lane J.C.
        • Craig R.S.
        • Rees J.L.
        • et al.
        Low rate of subsequent surgery and serious complications following intra-articular steroid injection for base of thumb osteoarthritis: national cohort analysis.
        Rheumatology (Oxford). 2021; 60: 4262-4271
        • Lane J.C.
        • Craig R.
        • Rees J.L.
        • et al.
        Low rates of serious complications and further procedures following surgery for base of thumb osteoarthritis: analysis of a national cohort of 43 076 surgeries.
        BMJ Open. 2021; 11e045614

      Linked Article

      • Reply to “Letter Regarding ‘Risk of Infection in Thumb Carpometacarpal Surgery After Corticosteroid Injection’”
        Journal of Hand SurgeryVol. 47Issue 4
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          We thank Patel et al1 for the excellent points raised by them and appreciate the opportunity to respond. It is indeed interesting that although their work found that a preoperative corticosteroid injection is associated with a greater risk of a serious surgical site infection after surgery, the absolute proportion of surgical site infections was several orders of magnitude lower than that in our study. This difference could be attributed to differences in coding. All large national databases are subject to imprecisions in coding, including the database used in our study.
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