Thumb arthroplasty is a surgical procedure to treat arthritis affecting the joint at the base of the thumb. This surgery helps restore mobility and function to the thumb.
The thumb is an important part of the hand as it helps to perform a wide range of movements such as pinching and grasping, which are used in daily activities. These movements are enabled by bones that run from the tip of the thumb to the wrist. The thumb articulates with a bone in the palm called the first metacarpal, which in turn articulates with a wrist bone called the trapezium. The joint between the first metacarpal and the trapezium is called the carpometacarpal (CMC) joint. Each joint is lined by articular cartilage, which helps in smooth, frictionless movement. Loss of cartilage due to wear and tear causes painful rubbing of the bones. This condition is called osteoarthritis, and is associated with pain, swelling and stiffness. Osteoarthritis commonly affects the CMC joint of the thumb, limiting its movement. Thumb osteoarthritis is commonly seen in women over the age of 40 and those with a previous history of trauma to the joint.
Thumb arthritis may be initially treated non-surgically with ice applications, anti-inflammatory medications, splints, and steroid injections. However, because arthritis is a progressive condition, the symptoms of pain, swelling and loss of function gradually become worse and non-surgical options may no longer work. This is when thumb arthroplasty surgery is indicated.
Thumb Arthroplasty Surgery may be performed under general or local anesthesia.
Following surgery, your thumb and wrist are placed in a bandage and supported by a splint leaving your fingers as well as the tip of your thumb free to move. You are advised to keep the hand elevated and apply ice to minimize pain and swelling. Movement of the hand is encouraged in the splint. The area needs to be kept dry. The splint will be replaced by a cast which is worn for three weeks. After one month, the patient may start using the hand for daily functions protected in a hand based CMC splint. This is followed by rehabilitation exercises initially to control pain and swelling and later to restore strength and movement. You can resume your daily activities in 3 to 6 months.
As with all surgical techniques thumb arthroplasty may be associated with certain risks and complications including: