Thumb (CMC) Arthritis

Thumb CMC arthritis, also known as basal joint arthritis or carpometacarpal arthritis, is a degenerative condition that affects the carpometacarpal joint at the base of the thumb, leading to pain, stiffness, and reduced function.

The most common cause of thumb CMC arthritis is osteoarthritis, a degenerative arthritis resulting from wear and tear on the joint. Other factors, such as rheumatoid arthritis, family history, and prior injury, can also contribute to the development of CMC joint arthritis.

Symptoms of thumb CMC arthritis include pain at the base of the thumb, weakness with pinching or grasping activities, and aching or soreness with prolonged use. CMC joint pain may worsen during pinching or grasping activities.

Non-surgical treatments for thumb CMC arthritis include anti-inflammatory medications, ointments, splinting or bracing, activity or ergonomic modifications, physical therapy, hand therapy, and steroid injections for worsening pain.

Surgery is considered for thumb CMC arthritis when non-operative treatments fail to control pain or improve function, and the patient's quality of life is significantly impacted.

Surgical options for thumb CMC arthritis include trapeziectomy, ligament reconstruction and tendon interposition (LRTI), suspensionplasty, Tightrope, fat grafting, and joint denervation. The choice of surgery depends on the severity of the condition and the patient's individual needs.

Trapeziectomy is a surgical procedure that involves removing some or all of the trapezium bone at the CMC joint to alleviate pain and improve function in patients with thumb CMC arthritis.

LRTI is a surgical technique used to treat thumb CMC arthritis, in which the trapezium is removed and the joint is reconstructed using the patient's own tendons to maintain the proper position of the thumb.

Suspensionplasty is a surgical procedure for thumb CMC arthritis that involves removing the trapezium and suspending the thumb metacarpal using a tendon graft or a synthetic suture material in order to maintain the thumb's stability and alignment.

Fat grafting is a newer treatment for less severe thumb CMC arthritis, in which fat is harvested from the patient's body and injected into the CMC joint. In some cases, this can lead to significant pain relief and either eliminate or delay the need for more extensive surgery.

Joint denervation is a surgical procedure that involves cutting the nerves responsible for transmitting pain signals from the thumb CMC joint .

Recovery after thumb CMC arthritis surgery typically involves wearing a splint or cast for up to 6 weeks. A hand therapist will work closely with you to help regain strength and motion. Full recovery may take several months, but most patients can resume their regular activities once recovered.

Surgery for thumb CMC arthritis is generally effective in reducing pain and improving function. The choice of surgical technique depends on the severity of the condition and the patient's individual needs, but most patients have significant improvement in their pain, function, and quality of life after recovering from surgery.

While it is possible for arthritis to recur or develop in other joints after surgery, most patients experience long-lasting relief from thumb CMC arthritis symptoms after undergoing an appropriate surgical procedure.

While it may not be possible to completely prevent thumb CMC arthritis, individuals can reduce the risk of developing this condition or causing progression by avoiding repetitive stress on the thumb and avoiding activities that can increase loads across the thumb, such as forceful pinching or grasping.

CMC arthritis is a progressive condition. The cartilage damage cannot heal itself and often the pain and symptoms tend to worsen with use and with time.

While there is no definitive cure for CMC arthritis, its symptoms typically can be effectively managed through non-surgical treatments or surgery, depending on the severity of the condition and the patient's individual needs.

Early signs and symptoms of CMC thumb arthritis may include pain at the base of the thumb, stiffness, and difficulty with pinching or grasping activities. Pain may worsen during activities that require thumb use, such as opening jars or turning door handles.