Trapeziometacarpal joint replacement: An economical comparison between WALANT and plexus block anesthesia

Abstract

The study "Cost and Efficiency Benefits of WALANT for Trapeziometacarpal Joint Implantation Arthroplasty" aimed to compare the cost-effectiveness and efficiency of the "wide awake local anesthesia, no tourniquet" (WALANT) technique to the traditional axillary block (AB) anesthesia in trapeziometacarpal (TMC) joint arthroplasty.In this monocentric retrospective study, 39 patients who underwent TMC joint arthroplasty were divided into two groups: 10 with WALANT and 29 with AB. The results showed that WALANT led to an 18.7% reduction in costs compared to AB, with total operating room (OR) time being 5 minutes shorter for the WALANT group. Despite similar surgical times, the "all-but-surgery" time (OR time excluding surgery) was reduced for WALANT, contributing to these savings. Patients in the WALANT group reported minimal pain during surgery and low postoperative pain, with opioid use discontinued by day 3.The study concluded that WALANT is an efficient, cost-effective alternative for TMC joint arthroplasty, providing similar patient experience in terms of pain and recovery while optimizing OR time and reducing costs. However, it noted limitations such as a small sample size and the non-randomized nature of anesthesia choice. Further studies are recommended to confirm these findings.