Basal Joint Arthritis of the Thumb

Osteoarthritis of the basal joint of the thumb

As explained on a surgical article published on drbadia.com, Osteoarthritis of the basal joint of the thumb is the second most common location for arthritis in the hand. However, it is by far the most functionally disabling. While distal interphalangeal joint arthritis is much more common, it is often minimally symptomatic, and the only good treatment option is fusion of this joint. This method of treatment is simple, and the results are reproducible with excellent return of function. Conversely, due to the many degrees of freedom involved in basal joint motion, the treatment is much more complex and the results less predictable. Not only is motion at this joint so functionally critical, but incredible stresses are transmitted across the basal joint even with simple, everyday activities. The forces seen at the tip during pinch, for example, are transmitted tenfold to the base of the thumb.

Surgical Options for Thumb Basal Joint Arthritis

Complete excision of the trapezium
A more complex modification of this procedure has been described as the LRTI (ligament reconstruction tendon interposition)
Total joint arthroplasty with silicone replacement
Total joint arthroplasty using a semi-constrained, cemented implant
Arthroscopy may be most beneficial in the early stages of basal joint arthritis
More advanced arthroscopic stages dictate more aggressive treatment