The thumb is designed to give you a wide range of motion, enabling you to pinch, grip and grasp objects. Splints of this type are commonly worn during the day and may also be worn at night while sleeping. The most common early complaint involves difficulty opening jars or bottle screwcaps. 2012 Feb 3. Remember, you are an active participant in your care, and part of your recovery depends on your desire to participate in therapy. Although there are several types of arthritis, the one that most often affects the joint at the base of the thumb (the basal joint) is osteoarthritis (degenerative or "wear-and-tear" arthritis). How does cutting out a bone help relieve thumb pain? The “gri… The damaged joint surfaces are removed and replaced with a cushion of tissue that keeps the bones separated. You will be placed into a short forearm-based cast that goes out your thumb, called a thumb spica. It is ironic that we have come full circle regarding surgical treatment, since Meals recently described a similar procedure in the literature nearly 50 years later. N… In this outpatient procedure, the surgeon excises the trapezium and transfers a tendon from the forearm to the trapezial space. Thank you for choosing Palm Beach Hand to Shoulder for your upper extremity care. Symptomatic patients with early-stage arthritis usually respond to behavior modification (e.g., limiting thumb motion), treatment with nonsteroidal anti-inflammatory medications, or splinting. A more complex modification of this procedure has been described as the LRTI (ligament reconstruction tendon interposition… The basal joint allows your thumb to move around so you can perform small motor tasks. This was a simple operation, first described by Gervis in 1949. Basal joint arthritis is a degenerative condition, which only responds temporarily to non-invasive treatment. After surgery, you will have to wear a thumb splint for 4-8 weeks, depending on what surgical procedure is used. Be sure the doctor or midlevel provider is familiar with all of the possible causes of basilar thumb pain. J Hand Surg Am. The majority of patients return to most activities by 3 months after surgery. To accomplish this, surgeons remove all or part of the trapezium bone in the wrist at the base of the thumb. Three to 4 weeks after the procedure, the cast is removed and active range-of-motion therapy begins. Discussion This study shows that thumb basal joint arthritis and SLAC type wrist arthritis may be treated by combined treatment during the same intervention without any complications. Again, this procedure is for pain control, generally reserved for cases that do not respond to other treatments. Pain, stiffness, and / or swelling at the base of the thumb. During a physical exam, your doctor will ask about your symptoms and look for noticeable swelling or lumps on your joints.Your doctor might hold your joint while moving your thumb, with pressure, against your wrist bone. Removable splints for the basal joint of the thumb are used for two primary purposes: providing support to improve hand function and providing rest to decrease inflammation and pain. Basal Joint Arthritis/Thumb Arthritis Treatment and Surgery By Houston Hand Surgery Specialist & Orthopaedic Surgeon, Dr. Dean Smith Any condition that irritates or destroys a joint is called arthritis. I had a bit of a setback with some pain and redness, but most of that is resolved. Patients often present with pain, instability, or weakness associated with pinch motions or activities where the thumb bears weight. There are several options for the surgical treatment for arthritis of the thumb CMC joint. In this procedure, a wrist bone called the Trapezium is removed and replaced with a tendon taken from the patient’s forearm. Orthopaedic Sports Medicine and Shoulder Surgery Fellowship, Ranked #1 in Michigan and 21st in the nation. Review the clinical presentation of basal joint arthritis, conservative management strategies, when surgery is indicated, and what patients can expect after surgery. Welcome Dr. Syed Nabeel Zafar to the Division of Surgical Oncology! Patients are sent to an Occupational Therapist, with the goal of regaining functional use of the operative hand. For more information about surgery for basal joint arthritis, or to contact us, visit our UW Health webpage about hand and microsurgery. Arthritis at the Base of the Thumb (a.k.a. If a decision for surgery is made after seeing one of our Orthopaedic Hand Surgeons, you may require pre-operative medical clearance by our Anesthesia department or your Primary Care Provider. Trapeziometacarpal joint arthrodesis is usually reserved for the non-dominant hand in younger patients for whom pain reduction and long-term joint stability and strength are more important than mobility. Your doctor will provide you with specific restrictions. The joint is held in place with a pin for several weeks so the tissue can heal. Direct palpation usually reveals tenderness in the joint; depending on the stage of disease, the joint may appear swollen and/or the patient may have decreased range of motion. The splint is worn constantly, except for during bathing, for a period of a month. In a normal joint, cartilage covers the ends of the bones and allows them to move smoothly and painlessly against one another. COVID-19: Updated Visitors Policy. Hand surgery can provide a permanent solution, preventing permanent weakness and … Sometimes, the joints between neighboring wrist bones are involved, (including the Trapezoid and the Scaphoid), at which point the condition is called Pantrapezial Arthritis. Hand weakness can result due to the pain. If you have basal joint arthritis at the base of your thumb joint, you'll want to watch this video series! After several weeks to months of immobilization, you will likely be stiff and weak in your hand / wrist. The “grind test,” in which the physician gently grasps the patient’s thumb and grinds it like a peppermill, elicits pain in patients with basal joint arthritis. Measurements of grip and pinch strength can also help determine disease severity. Sometimes, the space is left alone to be filled with blood. Surgery is the last option available in the treatment of thumb arthritis. Nicotine is a vasoconstrictor, and can impede healing by limiting blood flow to the surgical site(s). Thumb Basal Joint (CMC) Arthritis - Palm Beach, FL. Thumb arthritis is common with aging and occurs when cartilage wears away from the ends of the bones that form the joint at the base of your thumb — also known as the carpometacarpal (CMC) joint.Thumb arthritis can cause severe pain, swelling, and decreased strength and range of motion, making it difficult to do simple tasks, such as turning doorknobs and opening jars. Many people have thumb pain which subsides after a few years, when the arthritis and irritation in this joint "burns out". Treatment generally involves a combination of medication and splints. Do not take it with other pain medicines unless directed by your doctor. Surgical Management: The primary goal of surgery for basilar thumb arthritis is pain relief. Arthritis is a condition that irritates or destroys a joint. Your doctor will discuss with you and decide on the best treatment for you. Patients often present with pain, instability, or weakness associated with pinch motions or activities where the thumb bears weight. If more information is needed, the doctor or midlevel provider may order a CT scan or an MRI. Masks are required throughout all facilities. According to the Mayo Clinic, thumb arthritis is the most co… In this video it's 6 weeks after the basal joint arthritis surgery. Basal joint arthritis of the thumb is common and can be disabling. Do not drive, drink alcohol, or make important decisions while taking the pain medicine. Most studies report high patient satisfaction rates and good short- and long-term pain relief after basal joint arthroplasty (1,2). Basal joint arthritis is usually seen in patients aged 50 to 70, and occurs more frequently in women than men. Please review carefully to ensure the best possible outcome. Basal Thumb Arthritis can be treated non-surgically or surgically depending on the severity of symptoms and level of disability. Non-surgical Management:The goal of treatment is to decrease pain in the basilar thumb joint. Imaging: Usually, imaging of the hand begins with x-rays. Total time for splint immobilization is approximately 3 months, with restrictions on use of the hand during that time.