Thumb Joint Replacement Surgery for Osteoarthritis

In addition to our large brain, another critical characteristic of being human is having opposable thumbs. Our thumb joints have a wide range of motion that enables us to pinch, grasp and manipulate objects in a way that is not possible for most other animals.

But while thumb joints have been credited with humanity’s ability to achieve technologic advancements, all of that motion results in a lot of wear and tear – increasing the risk of osteoarthritis in the joint where the thumb meets the bone in the wrist. In many cases osteoarthritis of the thumb can be treated without surgery.

However, severe osteoarthritis of the thumb can result in the need for thumb joint replacement surgery. In this article board certified Bloomfield Hills hand surgeon Dr. Uzma Rehman discusses the option of thumb joint replacement surgery for osteoarthritis pain and immobility.

What is Osteoarthritis of the Thumb?

Osteoarthritis is very common condition, affecting more than 30 million adults in the United States. Over time, the cartilage and fluid that cushions a joint simply wears out, causing the bones to rub together. This can cause pain, stiffness and swelling – and eventually loss of function in the thumb joint.

Most cases of Osteoarthritis can be well managed with nonsteroidal anti-inflammatory medications, activity modification, corticosteroid injections and/or hand therapy. Over-the-counter joint supplements such as glucosamine chondroitin, sulfate and turmeric may also help.

Only in rare, severe cases is do these conservative interventions stop helping osteoarthritis in the thumb, and surgery may be recommended for certain patients.

LRTI Arthroplasty Thumb Joint Replacement Surgery for Osteoarthritis

There are different types of thumb joint surgery available, but ligament reconstruction and tendon interposition (LRTI) arthroplasty is the most commonly performed surgery for thumb osteoarthritis.

This surgery is popular because it is highly effective at relieving pain – but doesn’t require fusion of the thumb joint. So, thumb motion and function are preserved.

During LRTI surgery, the hand surgeon makes a small incision over the thumb basilar joint, and a small bone called the trapezium is removed. Then she uses the patient’s own tissue (taken from a tendon) to reconstruct the joint and create a new joint cushion. In other cases, rather than soft tissue reconstruction, artificial joint replacement hardware may be used to replace the joint.

What to Expect During LRTI Thumb Joint Replacement Surgery

LRTI surgery is usually a same day, in-and-out surgical procedure after which the patient is sent home wearing a splint that immobilizes the wrist and thumb for two weeks. This may be followed by the use of a cast for about four weeks, then followed by a brace.

After joint immobile for roughly six weeks, depending on the individual patient, most patients can begin “gentle usage” of the thumb and will begin physical or occupational therapy to restore strength and function, as well as range of motion to the thumb joint.