Arthritis often affects an important joint at the base of the thumb in patients after fifty, known as the trapezio-metacarpal joint. Cartilage in the joint becomes worn and bare bone rubs against bare bone, which causes pain.

What causes basal thumb arthritis?

This joint is very mobile and the thumb is used in almost any hand function. It is no surprise that after forty of fifty years, this joint becomes damaged. A genetic predisposition exists.

Symptoms

Symptoms include pain and swelling at the base of the affected thumb along with decreased range of motion and weakening. A deformity can be present with advanced cases.

Diagnosis?

Physical examination and X-rays will determine whether you have this condition.

Functional treatment

Splinting, NSAIDs, cortisone injections can help alleviate the symptoms but when the pain becomes a real problem, surgery can be extremely useful.

Surgery

Different procedures are available to treat this condition.

Trapeziectomy

The most common is a resection of the trapezium. In this surgery, the trapezium bone is removed.

Arthroscopic debridement with implant interposition

A revolutionary less invasive approach allows to resect the diseased cartilage and 3 mm of the trapezium through keyhole incisions and to insert an absorbable implant between the trapezium and the metacarpal. This arthroscopic procedure cause only mild discomfort for a few days and requires immobilization for five weeks followed by hand therapy. This technique allows to treat the pain while preserving the anatomy of the thumb and without the need of taking out the trapezium bone. This state of the art procedure was imported from Europe, the USA and Japan. Dr. Brutus performed it for the first time in Canada in 2010.

Total joint replacement

Alternatively, you may also undergo a joint replacement, in which the joint is reconstructed with an implant, like for the hip or the knee. This joint replacement reconstruction allows faster and more complete recovery and better thumb strength but requires the use of an implant and will not last forever. However, when the implant fails, usually after several years, a formal trapeziectomy can still be performed.

Potential complications of surgery for arthritis of the thumb are rare but include pain, stiffness and nerve or tendon injury; implant related problems such as dislocation, infection and loosening over time.

Joint replacement for the thumb is not for everyone, as certain criteria must be met. Dr. Brutus specializes in these procedures and will be able to advise you on the best option for your needs.

Basal thumb arthritis3

Basal thumb arthritis

Basal thumb arthritis2