Thumb Basilar Arthritis

A common but easily treated problem. If surgery is needed, it works great for getting you back to using the hand normally again!

What is it?
Any condition that irritates or destroys a joint is called arthritis. In a normal joint, cartilage covers the ends of the bones and allows them to move smoothly and painlessly against one another. With osteoarthritis (also called degenerative arthritis), the cartilage layer wears out and the bones rub against each other. As the cartilage layer continues to wear out, symptoms of arthritis develop and the joint is eventually destroyed.

What causes it?
It is caused by normal aging, and the accumulation of years of use. This joint bears a lot of pressure since the thumb is used so much compared to the other fingers.

Will it get worse?
It is possible for it to just go away, but most of the time, it is not likely to heal on its own. It will often progress and impair function of the whole hand because of pain, grinding, and a feeling of weakness.

What is the treatment?
Bracing and therapy are quite effective for this condition. Medicines like aspirin, Tylenol, Motrin and other anti-inflammatories may help with the symptoms. An injection given in the joint can resolve this problem. Sometimes 2 or even 3 injections might be necessary.

Do I need surgery?
Most patients do not need surgery for this, as most respond well to medicines and injections, at least initially. If symptoms continue, surgery is very helpful.

Tell me about the surgery
It is an outpatient surgery, meaning you go home the same day as surgery. It is done with complete anesthesia. It takes about 30 minutes, and is done through a very short (about 1 inch) incision which is often invisible after it is healed. After the surgeon incises the skin, the arthritic trapezium is removed. A ligament is rebuilt with local tissues to hold open the space left by the removed trapezium. There are very few complications, making this a very safe and effective procedure.

Is surgery safe?
Your surgeon will discuss the risks with you, but it is a very safe and effective procedure.

How long would I be out of my job after surgery?
You will be sent home with a brace on your hand and wrist. You should move your fingers the day of surgery, as this helps prevent and reduce swelling and stiffness. The stitches are absorbable and don't need to be removed. Jobs with clerical or light-type of work can be resumed within 1-2 weeks, heavier duty-type jobs such as manual labor can be done after 6-8 weeks in most cases. Many people have returned to their jobs the day after surgery - it really depends on the job type more than anything.