Basal joint arthritis is a condition that irritates or destroys the joint at the base of the thumb. The cartilage that normally covers the ends of the bones begins to deteriorate, allowing the bones to rub against each other. The result is significant damage that can cause severe pain and drastically limit thumb movement. Common activities such as opening jars, turning door knobs or buttoning clothing can become difficult or impossible if the condition continues to worsen.
Treatment
Diagnosis of arthritis at the base of the thumb is based upon a carefully performed physical examination and review of medical history with confirmation by X-rays. This allows us to stage the arthritis as early, mild, moderate or severe.
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In early stages, splinting and medications may be beneficial while more severe cases may require surgery. The goal of surgery is to eliminate the pain at the base of the thumb by creating a new joint. The procedure can improve the position of the thumb, its range of motion and the hand’s strength for pinching and grasping.
Two types of surgery are currently available to us to maintain motion. The traditional surgery, useful for patients with advanced disease, involves removing the entire trapezium bone and then using a tendon from the forearm to suspend the thumb and to act as an interposition material. This is referred to a “Ligament Reconstruction Tendon Interposition” Arthroplasty (LRTI).
The newer approach, for earlier stage painful arthritis at the base of the thumb, involves removing only two millimeters of the diseased portion of the trapezium bone. A spacer made of woven, biodegradable material is then inserted between the two bones to eliminate the rubbing of the rough surfaces and diminish pain. Thumb length, which is important to strength, is also maintained. |
