Surgery for Thumb and Digit Arthritis

What is Thumb Arthritis?

Arthritis is an inflammatory condition of the joints. There are several types of arthritis; the most common type is osteoarthritis or wear-and-tear arthritis that affects the joint at the base of the thumb. Thumb arthritis is more common in women than men, and usually occurs after the age of 40 years. Arthritis of the fingers causes swelling, pain, stiffness and malformation, all of which interfere with the use of the hand.

Non-surgical Treatment for Thumb and Digit Arthritis

Non-surgical treatment methods for relieving pain in an arthritic joint include activity modification, pain medications, and use of splints, and steroid injections.

Surgical Treatment for Thumb and Digit Arthritis

Surgery is usually considered if non-surgical treatments fail to offer relief. There are different surgical procedures that can be performed and may include:

• Synovectomy: This surgery is usually indicated for early cases of inflammatory arthritis that is associated with significant swelling (synovitis), pain and limited range of motion of the digits and thumb. Synovectomy is a surgical removal of the inflamed synovium (tissue lining the joint). The procedure may be performed using arthroscopy.
• Arthroplasty: In this procedure, your surgeon removes the affected joint and replaces it with an artificial implant. In post-traumatic arthritis and osteoarthritis, where the bone is hard and demand on the hand is moderate, new ceramic implants are used. These are not desirable for severely damaged or unstable joints. In inflammatory arthritis, where the bone is not strong enough and the demand on the hand is low, older silicone rubber joints are generally used. These can be used for more severe joint damage and unstable joints.
• Arthrodesis: A fusion, also called an arthrodesis, involves the removal of the joints and fusing of the bones of the joint together using metal wires or screws. Even though this surgery eliminates all motion at the base of the thumb, the resulting fusion is very hard. This surgery is usually indicated when the joints are severely damaged, when there is limited mobility, damage to the surrounding ligaments and tendons, failed previous arthroplasty, and when heavy manual use is expected.

Your surgeon will discuss the options and help you decide which type of surgery is the most appropriate for you.

Rehabilitation following Surgery for Thumb and Digit Arthritis

Following surgery, a rehabilitation programme, often involving a physiotherapist may help to regain hand strength and movement. You may need to use a postoperative splint for a while after surgery that helps to protect the hand while it heals. You may need to restrict activities for a minimum of 12 weeks to let the joint reconstruction heal properly. Although recovery is slow, you should be able to resume your normal activities within a few months of surgery.