Treatment For Thumb Arthritis: When To Consider Carpometacarpal (CMC) Arthroplasty

Can Thumb Joint Replacement Surgery Treat Thumb Arthritis?

Arthritis in the thumb is a natural part of aging. The condition is caused by the wearing away of cartilage that separates the end of the adjacent bones. Cartilage degeneration leads to pain, swelling, and limited hand flexibility and strength. When the thumb arthritis is severe, doctors may recommend total joint replacement, also known as carpometacarpal arthroplasty.

How does thumb arthritis develop?

Thumb arthritis begins when the ligaments that support the trapeziometacarpal joint loosen. The unstable structure leads to the wearing away of the articular cartilage that protects the ends of bones. Arthritic conditions such as rheumatoid arthritis (RA) can also worsen thumb joint pain and stiffness. Treatment for thumb arthritis should begin as early as possible.

Conservative treatment options

Surgery is recommended when nonsurgical intervention has failed. Oral and topical pain medication can provide localized pain relief for mild cases of thumb arthritis. Splints can help decrease thumb pain by supporting the joint and limiting movement around the area. For severe cases, steroid injections can provide temporary pain and inflammatory relief.

Surgical treatments for thumb arthritis

Surgical treatment options will depend on the severity of the thumb pain and cartilage wear. A joint fusion, also known as arthrodesis, permanently fuses the joints to remove pain, albeit, the thumb will lose flexibility. An osteotomy repositions the joint to improve function. A trapeziectomy removes the trapezium bone in the thumb to relieve the pain.

What is carpometacarpal (CMC) arthroplasty?

The carpometacarpal joint is located at the base of the thumb and aids in many hand movements. When the cartilage shock absorber wears away, surgeons may recommend an arthroplasty to remove and replace the joint with a skin graft or an artificial implant made out of silicone, metal, or pyrocarbon.

Recovering from CMC joint replacement

As with any traditional surgery procedure, patients are advised to follow a strict protocol to promote faster and better healing. Caring for the stitches, dressing, and splint reduces the risk of infection. Rehabilitation can include finger exercises to help patients form a fist and fully extend the fingers, a great sign of a successful arthroplasty. For more information about thumb arthritis, speak with an orthopedic specialist or hand surgeon.