Osteoarthritis, also known as degenerative arthritis, is a mechanical abnormality, involving degradation of the joint cartilage and bone. Symptoms include joint pain, stiffness, locking and sometimes, swelling as a result of a joint effusion. All joints are predisposed to developing arthritis.
Arthritis of the thumb basal joint, in particular affecting the first carpometacarpal joint, is a frequent sight due to its relative instability and high use. This happens when the cushioning cartilage of the joint surfaces wears away, resulting in damage to the thumb joint. Pain at the base of the thumb happens when moving the thumb and sometimes persists even at rest.
Various causes – hereditary, developmental, metabolic and mechanical deficits – may initiate and exacerbate the loss of cartilage. Ligament injuries and laxity may also exacerbate the lesion.
Diagnosis is based a combination of clinical findings as radiologic imaging (Figure A).
Differentials include fracture, carpal tunnel syndrome and other inflammatory joint arthritis.Discuss the different options with the hand specialist looking after you so that the most appropriate modality is chosen.
Treatment for thumb arthritis involves multiple modalities, including activity modification, rest, immobilization, analgesia and even surgery.
A resting thumb spica splint is usually prescribed in the initial stage (Figure B). This can be further supplemented with corticosteroid or hyaluronic acid injections.
If conservative management does not reduce or control the symptoms, then surgical treatment is indicated.
Various surgical options are available, depending on the severity of the lesion:
Discuss the different options with the hand specialist looking after you so that the most appropriate modality is chosen.
If you would like to learn more about the treatment and the possible outcomes, feel free to inquire here.