Thumb Arthritis Surgery

The human’s opposable thumb is one of the species’ most distinguishing features. It allows people to pinch, grasp, and manipulate objects that other animals can’t manage. A condition such as thumb arthritis that limits the thumb’s functionality can have significant impact on daily activities. Although you can find many devices on the market that make it easier to turn doorknobs, open cans, and button shirts without a full range of motion in the thumb, these solutions may not be what you seek.

Thumb surgery is a compelling option that can relieve pain and restore some functionality of the thumb joint. If you’re suffering from thumb arthritis, several treatment options exist.

What Is Thumb Arthritis?

Thumb arthritis is a condition that occurs when the cartilage wears away from the bones that make up the thumb joint where it meets the wrist. Also known as the carpometacarpal (CMC) joint, this essential part of the hand is responsible for actions such as grasping and pinching movements. In a healthy CMC joint, cartilage covers the ends of the bones, allowing them to move smoothly. When the cartilage breaks down, bone on bone occurs, causing friction, pain, and joint damage.

Osteoarthritis is the most common type of arthritis affecting the thumb joint, but rheumatoid arthritis may cause this problem. Thumb arthritis is most common after the age of 40, and it impacts more women than men. Among people in their 50s, 60s, and 70s, about 50% have some degree of thumb arthritis, according to information from Yale Medicine.

Symptoms of Thumb Arthritis

The most common sign of thumb arthritis is pain in this joint. You’re likely to notice this discomfort when grabbing or pinching objects. Thumb arthritis can also cause you to develop a bone spur along the joint, creating a small bump at the base of the thumb. Swelling, tenderness, and a prolonged ache may accompany your thumb pain. This type of arthritis can also cause a limited range of motion in the thumb and a loss of strength when pinching or grabbing items.

Diagnosing Thumb Arthritis

To diagnose thumb arthritis, your doctor will perform a physical examination and ask you about your symptoms. The doctor will look for swelling and signs of bone spurs by gently manipulating the thumb. Pain, grinding sounds, or a gritty feeling with this movement are prime indicators of thumb arthritis. An X-ray can confirm this diagnosis.

Treatments for Thumb Arthritis

Several preliminary treatments may help with thumb arthritis, including:

• Topical pain medication.
• Over-the-counter or prescription pain relievers.
• A splint to limit movement of the thumb and wrist.
• Corticosteroid injections in the thumb joint.

If these treatments don’t have a noticeable impact on your pain and discomfort, or you’re suffering from a severely limited range of motion, you might consider surgery for thumb arthritis. 

Types of Surgery for Thumb Arthritis

Several types of surgery can help treat thumb arthritis. Your doctor can help you explore these options and determine which best fits your individual needs.

Ligament Reconstruction and Tendon Interposition (LRTI)

LRTI has long been the standard choice for thumb arthritis surgery for more than four decades. This surgery involves removing some or all of the trapezium bone and reconstructing the ligament using the flexor carpi radialis. The surgeon drills a hole in the thumb’s metacarpal bone and passes this tendon through it, positioning the tendon in the spot of the bone’s removal. Alternatively, the surgeon may use an artificial tendon rather than move the existing one.

This surgery has a 96% success rate, according to information cited by the Arthritis Foundation. However, the recovery period may last from four to six weeks and is often painful. The surgery shortens the thumb noticeably and may decrease pinch strength and grasping ability.

Ligament Reconstruction

Ligament reconstruction is similar to LRTI, but surgeons have more options when performing this surgery. The surgeon may remove the damaged ligament and replace it with part of the patient’s wrist flexor tendon without removing the trapezium bone if the arthritis is in the early stages and significant cartilage loss doesn’t exist.

Surgeons may use a FiberWire ligament reconstruction technique if cartilage loss has occurred. With this procedure, surgeons remove the trapezium and use FiberWire to anchor the thumb to the index finger. This technique reduces recovery time to only three months and provides less stiffness in the wrist.

Arthrodesis

Arthrodesis is the process of fusing the affected joints permanently. The surgeon creates a socket hole in the thumb’s metacarpal bone and shapes the trapezium to fit inside it. The surgeon then places a metal pin to hold the bones in position while they fuse. This fusion eliminates pain but can reduce mobility. Up to 21% of people require a second surgery.

Osteotomy

An osteotomy repositions the bones in the thumb to relieve pain and pressure. The procedure can correct the mispositioned bones in the early stages of thumb arthritis and stop the condition from worsening. This surgery is best suited to younger patients. 

Arthroplasty

Arthroplasty is a total joint replacement. A surgeon removes the thumb joint during this surgical procedure and replaces it with an artificial one. This joint implant takes a pyrocarbon prosthesis or metal form. The surgeon also places synthetic spacers between the bones to cushion them. 

This surgery offers fast recovery and much easier rehabilitation than other options. Unfortunately, the complication rate is higher than for most other thumb arthritis surgeries, and some patients continue to experience pain and inflammation.

Most patients with thumb arthritis experience a gradual worsening of symptoms that eventually lead to thumb arthritis surgery. With many options available, various approaches exist to suit patients’ needs. Speak with your doctor about your risk averseness, symptoms, and desired results to find the right solution for your concerns about thumb arthritis.

Contact Dr. Knight at The Hand and Wrist Institute Today!

If you have arthritis in your thumb, contact our doctors at The Hand and Wrist Institute. We specialize in treating this part of the body and offer several surgical solutions that may help relieve your pain and improve motion in the thumb joint. Learn more about your treatment options today.

Dr. John Knight

Dr. Knight is a renowned hand, wrist and upper extremity surgeon with over 25 years of experience. Dr. Knight is a Board Certified Orthopedic Surgeon and Fellowship trained. Dr Knight has appeared on CNN, The Doctors TV, Good Morning America, The Wall Street Journal, The Washington Post, Forbes, The Huffington Post, Entrepreneur, Oxygen network and more.