Surgical Information - Procedure

Surgery for Basal Joint (Thumb) Arthritis

What are the surgical options for basal joint arthritis?

Basal joint arthritis, or thumb arthritis, is the most common form of osteoarthritis affecting the hand. It occurs when the cushioning cartilage wears away from the ends of the bones that form the thumb joint.

A number of surgical techniques are available that can successfully reduce or eliminate pain. They include:

  • Joint fusion, in which the surgeon permanently fuses the bones in the thumb joint to increase stability and reduce pain. The fused joint can bear weight, but has no flexibility.
  • Osteotomy (bone cutting), in which the surgeon repositions the bones in the thumb joint to help correct deformities.
  • Trapeziectomy, in which the surgeon removes the trapezium, one of the bones in the thumb joint.
  • Thumb arthroplasty (joint replacement), in which the surgeon removes part or all of the thumb joint and replaces it with a tendon graft.

It is important that each patient is thoroughly screened by an orthopaedic surgeon to determine the most appropriate option.

Anatomy

The thumb basal joint is a specialized, saddle-shaped joint formed by the trapezium and the metacarpal (first bone of the thumb). The basal joint allows the thumb to swivel, pivot and pinch so you can grip things in your hand.

Thumb arthritis occurs when the cartilage that covers the ends of the bones in the thumb joint gradually wears away. Without the cushioning effect of cartilage, the bones rub together. The thumb can't move easily and becomes stiff, swollen and painful.

When is surgery recommended?

If you have pain or stiffness at the base of your thumb that limits your everyday activities, and all non-surgical methods of treatment have failed – including splinting, non-steroidal anti-inflammatory drugs, prescription pain relievers and injectable corticosteroids – then you should consider surgery.

A consultation with your hand surgeon can help determine the best surgical option for you.

What is the recovery time?

All of the surgical options listed above can be performed on an outpatient basis, but it takes time to regain strength and range of motion. After surgery, you can expect to wear a cast or splint over your thumb and wrist for six to eight weeks, depending on which procedure is used. Once the cast is removed, physical therapy begins to regain hand strength and movement. Full recovery from surgery varies by patient, but most are able to resume normal activities within six months.

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