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Reconstructive Techniques for Thumb Basal Joint Arthritis

a man shows his hands with thumb basal joint arthritis as he tries to write in a daily planner
Sufferers of thumb basal joint arthritis complain of weakness, stiffness and pain in the joint base of their thumb, making tasks like writing difficult.

Thumb basal joint arthritis, also known as trapeziometacarpal (TMC) arthritis, is a common condition that affects the joint at the base of the thumb.

This joint plays a crucial role in hand function, and when it becomes arthritic, it can cause pain, stiffness, and weakness, making everyday tasks like grasping, pinching, and turning objects difficult.

Fortunately, various reconstructive techniques can help restore function and ease pain for those suffering from this condition.

Understanding Thumb Basal Joint Arthritis

Thumb basal joint arthritis occurs when the cartilage that cushions the joint wears away, leading to bone-on-bone contact. This can result from age-related wear and tear, previous injury, or underlying conditions like rheumatoid arthritis.

Symptoms typically include:

  • Pain at the Base of the Thumb:This pain may worsen with activities that involve grasping or pinching.
  • Swelling and Stiffness:The joint may appear swollen and feel stiff, especially in the morning.
  • Decreased Strength and Range of Motion:Weakness in the thumb and difficulty moving the joint are common.

Reconstructive Techniques

When conservative treatments like splints, medication, and physical therapy fail to provide adequate relief, reconstructive surgery may be considered.

Here are some of the latest surgical options available:

  1. Ligament Reconstruction and Tendon Interposition (LRTI):In this procedure, the damaged ligament is replaced with a tendon from the forearm. The tendon acts as a cushion between the bones, reducing pain and improving stability.

LRTI is often recommended for younger patients with early-stage arthritis and good bone quality. Recovery typically involves immobilization in a cast for a few weeks, followed by hand therapy to restore strength and function.

  1. Trapeziectomy with or without Ligament Reconstruction:This involves removing the trapezium bone, which forms part of the thumb basal joint. The space left behind is filled with a rolled-up tendon or synthetic implant to provide cushioning.

Trapeziectomy can be combined with ligament reconstruction for added stability. This procedure is suitable for patients with more advanced arthritis or those who have not responded to LRTI.

Recovery is similar to LRTI, with immobilization and hand therapy playing essential roles.

  1. Pyrocarbon Implant Arthroplasty:In this technique, the trapezium bone is replaced with a pyrocarbon implant that mimics the natural joint. This option can provide pain relief and a good range of motion. It is usually recommended for patients with advanced arthritis who still have good bone quality.

Recovery involves a period of immobilization and hand therapy to regain function.

  1. Joint Fusion (Arthrodesis):This procedure involves fusing the bones of the thumb basal jointtogether. While it eliminates pain, it also sacrifices some range of motion.

Joint fusion is typically reserved for patients with severe arthritis or those who have not benefited from other reconstructive techniques.

Recovery involves immobilization and a longer period of rehabilitation.

Choosing the Right Technique

a woman stretches her hands to relieve arthritis pain
Hand therapy is one treatment that orthopedic hand doctors may recommend as part of a plan to recover from surgery.

The most suitable reconstructive technique for you will depend on several factors, including:

  • Severity of Arthritis:The extent of joint damage will influence the choice of procedure.
  • Age and Activity Level:Younger, more active patients may be better candidates for LRTI, while older patients may benefit from trapeziectomy or joint fusion.
  • Bone Quality:Procedures like pyrocarbon implant arthroplasty require good bone quality for successful implantation.
  • Surgeon’s Expertise:Choosing a surgeon experienced in various reconstructive techniques is essential for optimal outcomes.

Recommended Read: Arthritis Care for Seniors: Tips and Therapies

Recovery and Rehabilitation

Recovery after thumb basal joint surgery typically involves:

  • Immobilization:The thumb will be immobilized in a cast or splint for several weeks to protect the healing tissues.
  • Pain Management:Your surgeon will prescribe pain medication to manage discomfort.
  • Hand Therapy:Hand therapy is essential to regain strength, flexibility, and range of motion.

Houston Physicians’ Hospital: Your Hand Health Experts

At Houston Physicians’ Hospital, we understand the debilitating impact of thumb arthritis on your daily life. Our team of skilled orthopedic surgeons specializes in various reconstructive techniques. We help you regain hand function and alleviate pain.

If you suffer from arthritic pain in your hands, you can visit our website on hand and wrist pain to learn more about symptoms and treatments. You can also scroll down to the bottom of the page to find an orthopedic hand surgeon who’s right for you.

Houston Physician’s Hospital also offers comprehensive care for a range of orthopedic conditions, including hip joint pain and knee pain. Our Joint Solutions Center is dedicated to providing personalized care for various joint issues, while our Spine Center in Houston, offers expertise in addressing spine pain and other related conditions.

If you’re seeking relief from thumb arthritis or any other orthopedic condition, we encourage you to reach out to our specialists.