What is Thumb Arthritis?
Thumb arthritis, otherwise known as basilar thumb arthritis or thumb CMC (carpometacarpal) arthritis is a very common form of arthritis in the hand that can have a significant impact on lifestyle and work. It affects an estimated 15% of people above the age of 30 and 35% of those above the age of 55.
The significant amount of force transmitted through the thumb CMC during everyday actions such as grasping and pinching, make this joint particularly vulnerable to wear and tear. In fact, these forces are 13 times greater than those seen at the tip of the thumb. As arthritis progresses, cartilage wears down to bone-on-bone, bone spurs form, and the surrounding ligaments cease to function normally. All of these changes to the CMC result in pain and disability in the use of the thumb.
What are the Symptoms of Thumb Arthritis?
- Pain with use of the thumb, especially with pinching, grasping – common actions include turning a key or opening a jar
- Decreased strength in the hand
- Stiffness and cramping of the thumb with activity
- Limited range of motion
- Swelling and a “bump” at the base of the thumb
- Grinding or clicking with motion of the thumb
What Treatments are Available for Thumb Arthritis?
There are two categories of treatment for thumb arthritis: non-operative and operative. Our goal is always to alleviate pain and restore quality of life in the simplest way possible. Thus, patients are advised to begin with non-operative treatments.
Non-operative Treatments Include:
- Oral anti-inflammatory medicines (NSAIDs)
- Specifically designed splints that provide relief while allowing use of the thumb
- Cortisone injections
- Activity or job modification – assistive devices such as jar openers that prevent pain-causing activity
Operative Treatments Include:
- Thumb CMC joint reconstruction (arthroplasty)
What are the Different Types of Thumb CMC Reconstruction Surgery?
There are many different ways to reconstruct or replace the thumb CMC joint. Historically, the most common method is to use a tendon from the forearm to take the place of the removed trapezium bone. This method involves multiple incisions to harvest the tendon and reconstruct the thumb using drill holes through bone. There’s also the metal- and plastic-implant method, however, this technique can be associated with increased risk of infection, loosening, and breakage of the implant.
But an exciting new method now exists for treating thumb CMC arthritis. Known as the SpeedSpiral System, it involves just one small incision, a collagen implant, and accelerated rehabilitation. In this procedure, the trapezium bone is removed, the thumb is suspended in place with a suture, and the collagen implant is then used to replace the trapezium bone. This provides a stable new base for the thumb, one shown to increase pinch and grip strength when compared to traditional methods. Additionally, a splint is required for only about six weeks before a return to normal activities, and pain relief is faster.
Dr. Babovic, along with other leading hand surgeons across the country, has pioneered this method of thumb CMC surgery. He is the only surgeon to perform this procedure in Nevada.