Thumb osteoarthritis is the most common type of arthritis in the hands and the most common form of osteoarthritis affecting the upper limbs. It can be debilitating, causing pain, swelling and weakness in the thumbs and hands that can make it difficult to perform simple everyday tasks like tying your shoelaces, taking the lids off jars or turning a doorknob.
Causes of thumb osteoarthritis
It is caused by the loss of cartilage inside the thumb joint due to wear and tear. Genetics are also believed to play a key part in the development of the condition.
We use our thumbs continually throughout our waking lives and the loss of cartilage, which acts as a cushion inside the joint, can cause bone to rub against bone, resulting in severe pain and loss of function. Women are six times more likely than men to develop thumb arthritis.
Treatments for thumb osteoarthritis
Treatments for early stage thumb arthritis involve managing the pain and slowing the degeneration of the joint. Your orthopaedic consultant may suggest using ice and anti-inflammatory medication to reduce swelling, along with exercises to increase range of movement, splints to hold the thumb straight to allow the joint to rest and injections of corticosteroids into the joint for temporary pain-relief.
Conventional surgical approaches
However, osteoarthritis is a degenerative condition so you are likely to experience a worsening of symptoms and over time, surgery may become necessary. Conventional surgical treatments for thumb arthritis include:
- Trapeziectomy which is removing one of the wrist bones that is part of the thumb joint.
- Osteotomy which is moving the bones in your thumb joint, realigning them and trimming away any excess bony growth.
- Joint fusion which fuses together the bones in your thumb joint to improve stability and reduce pain. The disadvantage is that your thumb will no longer be flexible and you will be unable to perform certain everyday tasks.
Groundbreaking cartilage implants
Castle Orthopaedics is one of a handful of innovative orthopaedic surgeons that is offering a groundbreaking new approach to surgery for thumb osteoarthritis. The approach is called Cartiva Synthetic Cartilage Implant for the treatment of CMC Joint Osteoarthritis.
The implant, which is cylindrical and around 1cm wide, mimics the properties of natural cartilage, acting like a cushion inside the thumb joint so the bones no longer rub together and cause pain. No bones aer removed or fused, as with conventional surgical approaches, and the procedure has been found to restore much of the original strength to the thumb.
What to expect from a Cartiva Synthetic Cartilage Implant
Cartiva synthetic cartilage implant surgery is performed under local anaesthetic, which means the patient is awake but sedated throughout. A 1.5 inch incision is made at the back of the thumb and a hole is drilled into the first metacarpal (thumb bone). The implant is inserted into the hole and the incision is closed with stitches.
Patients normally go home the same day and wear a bandage for around 10 days. Physiotherapy helps with rehabilitation and strengthening the thumb joint. Within three to six months of surgery, the patient will normally have the same level of strength as someone who doesn’t have thumb osteoarthritis. Full recovery can take up to a year.
Who is it suitable for?
The procedure is suitable for anyone except patients with the most severe stage four arthritis as their joint is normally too damaged to be able to take an implant.
Outcomes
Because the procedure does not shorten the metacarpal bone it results in improved key pinch, tip pinch and grip strength compared to a conventional trapeziectomy. Key pinch strength of more than 100% is common and grip strength of more than 82%.
Studies conducted by Cartiva show a substantial and clinically meaningful reduction in pain using the Visual Analog Scale 12 months after surgery. Eighty per cent of Cartiva implant patients demonstrated a clinically meaningful reduction in pain from a baseline at 12 months. Functional activities were evaluated using the QuickDash score and showed a substantial improvement at 12 months.
Ninety four per cent of Cartiva implant patients showed a clinically meaningful reduction in disability from a baseline at 12 months.
If you are suffering from thumb osteoarthritis, talk to us about the possibilities of a Cartiva cartilage implant, along with conventional surgical procedures and non-surgical treatment options.
Castle Orthopaedics – Hand & Wrist Specialists
Following the lockdown, Castle Orthopaedics is now re-open for virtual and face to face appointments at both Spire Nottingham Hospital and BMI The Park Hospital. Surgery is now also being scheduled once again, which means that injuries requiring surgery can be treated.
Our orthopaedic consultants each specialise in a particular area of orthopaedics, giving you added peace of mind that you are receiving expert medical advice and highly tailored treatment.
Locations include:
BMI The Park Hospital
Sherwood Lodge Drive Burntstump Country Park, Arnold NG5 8RX
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Spire Nottingham Hospital
Tollerton Ln, Tollerton, Nottingham NG12 4GA
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