We use our thumbs continuously for even the simplest everyday tasks such as making a cup of tea, brushing our teeth or tying shoelaces. So, developing osteoarthritis of the thumb can be painful and debilitating.
What is thumb arthritis?
Unfortunately, as we age, thumb arthritis is very common. It is caused by the cartilage in our thumb joint (carpometacarpal joint), where the thumb joins the palm, becoming worn. Cartilage covers the ends of the bones stopping them from rubbing together and allowing them to move smoothly over each other. When the cartilage begins to wear away, there is friction in the joint as you move your thumbs which can cause inflammation, stiffness and pain. Bony spurs may develop which can produce noticeable lumps on your thumb joint. Your thumb may become difficult to move and the joint may be swollen and lose strength, making it hard to pinch or grasp objects.
What causes thumb arthritis?
Arthritis is a degenerative disease which means there is no cure for it and it can gradually worsen over time. Thumb arthritis is linked to ageing although certain hereditary conditions like different joint shapes or joint ligament laxity can make you more prone to developing the condition. Trauma/injuries can also lead to arthritis, or make already existing arthritis more symptomatic.
Once you have the condition you will find that using your thumbs can increase pain and discomfort. Thumb arthritis can also be linked to a previous trauma or injury to the thumb joint. It is common in people over the age of 50, particularly women.
Treatments for thumb arthritis
The treatment you are offered will depend how advanced your thumb arthritis is and how severe the symptoms are along with your wishes and ability to take time out. In the early stages, conservative treatment such as medication to relieve pain, exercises to strengthen the small muscles at the base of the thumb or splints to limit the movement of your thumb and wrist will normally be sufficient.
If these simple measures aren’t sufficient for what you want then injections of steroid into the joint can offer pain relief. For more advanced thumb arthritis, you may choose to undergo surgery.
Conventional surgical approaches to thumb arthritis include:
- Joint fusion (arthrodesis) – this involves permanently fusing the bones in the basal thumb joint. This relieves pain but means the joint is no longer moves. However thumb movement is a combination of several joints and only one is fused. You may be surprised with the movement you retain. A fusion is useful in people who need to retain strength following surgery.
- Trapeziectomy – this is the removal of the trapezium bone in your thumb. This is effective at relieving the pain of thumb arthritis but the joint does not normally regain its former “normal” strength.
- Denervation – this is where the soft tissue around the joint is surgically detached. This means pain signals from the joint are not perceived but the underlying arthritic condition continues. 70% of people get a 70% improvement in pain.
- Joint replacement (arthroplasty) – this includes a spectrum of implants and options. Cartiva, hemiarthroplasty and total joint replacement are possible.
Cartiva Synthetic Cartilage Implants
Here at Castle Orthopaedics we have pioneered a new approach to thumb arthritis which is producing excellent results. Cartiva Synthetic Cartilage Implants are cylindrical implants of synthetic cartilage that inserted into the thumb joint. These implants mimic the properties of natural cartilage, helping to restore strength and flexibility to the thumb.
Cartiva implant surgery is performed under regional anaesthetic. An incision is made at the back of the thumb and a hole is drilled into the thumb bone. The implant is inserted into the hole and the incision site is closed with stitches. Most patients go home the same day and are asked to follow a rehabilitation programme to support recovery of the thumb joint.
Outcomes of Cartiva implant surgery
After three to six months most patients have recovered good levels of strength in their thumb although full recovery may take up to a year. The procedure is suitable for some patients except those with later stage arthritis which involves the next joint down. Compared to conventional trapeziectomy, Cartiva implant surgery helps to improve pinch strength and grip.
For more information about Cartiva synthetic cartilage implant surgery and other treatments for thumb arthritis, talk to our specialist hand Consultant who can outline the best options for you.
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.
BMI The Park Hospital
Sherwood Lodge Drive Burntstump Country Park, Arnold NG5 8RX
Spire Nottingham Hospital
Tollerton Ln, Tollerton, Nottingham NG12 4GA