Treatment: Thumb base joint replacement

Thumb base joint replacement is an innovative, safe and effective surgical procedure that replaces the arthritic joint at the base of the thumb with an artificial “ball and socket” joint.

What is thumb base joint replacement?

Thumb base joint replacement is an innovative, safe and effective surgical procedure that replaces the arthritic joint at the base of the thumb with an artificial “ball and socket” joint. This procedure is performed on people with osteoarthritis of the trapeziometacarpal joint (TM joint). The TM joint is the joint where the base of the thumb meets the wrist.

Thumb base arthritis is most common in women over the age of 50, but can start at a younger age. Osteoarthritis is the most common cause of thumb base joint arthritis.

What happens during thumb base joint replacement surgery?

The surgery is performed under general anaesthesia, or regional anaesthesia (the arm is numbed, the patient awake or lightly sedated). During the surgery, the surgeon will make an incision at the base of the thumb, remove a small amount of the thumb metacarpal base, and implant the artificial joint. The incision will then be closed with stitches.

How should I prepare for my surgery?

There are a number of nonsurgical treatments available for thumb base joint arthritis that you can use to self-treat your condition while you wait for your surgery, including:
•    Rest
•    Ice
•    NSAIDs (nonsteroidal anti-inflammatory drugs)
•    Cortisone injections
•    Hand therapy and the use of specific splints 

Thumb base joint replacement is typically recommended for people with painful thumb base joint arthritis who have not had success with non-surgical treatments. This procedure is often preferred for younger, more active patients, but can be considered for all ages.

What are the risks of this type of surgery?

There are a few risks associated with thumb base joint surgery:

  • Risk of dislocation (3-4%)
  • Risk of gradual loosening of the implant (approximately 85% of implants are still in place 8-10 years after surgery)
  • May need revision surgery in the future – either with another implant, or another type of surgery called a trapeziectomy which will remove the trapezium bone in the affected joint

What is the recovery process?

After surgery, a cast will be applied to your hand, and you will be given a sling to wear for a short period of time. You will be asked to wear a splint until 6 weeks after the operation. You will be able to resume light activities relatively soon after surgery, but it may take a few months to regain full strength and range of motion in your thumb.