Wheelchairs: Mobility Options for You

Severe Basilar Thumb Arthritis? Consider Surgery

Your thumb may be a small part of your body in comparison to your legs and arms, but it is an important part nonetheless. You don't always realize how much you use and rely on your thumb until you develop arthritis in the basilar joint, which is the joint where your thumb attaches to your hand. This arthritis can make it tough to do everything from grasping a glass to tying your shoes. At first, taking NSAIDS and applying topical pain relievers may give you enough relief, but when this stops working, it's time to consider surgery. Here's a basic overview of what orthopedic surgery for basilar thumb arthritis tends to look like.

What will the basic surgical procedure entail?

There are actually a couple of different surgeries that an orthopedic doctor may perform on patients with basilar thumb arthritis. Your doctor will use tests such as strength tests and imaging techniques (often an MRI) to determine the extent of your arthritis and decide which approach will be best. The three most common approaches are:

  1. Ligament Reconstruction: If a lot of your pain is due to ligament damage, your surgeon may remove the damaged ligament and replace it with a piece of tendon from elsewhere in your body. 
  2. Trapezium Wiring: If your pain is due to a lot of wear and friction on the trapezium bone, which is the bone to which your thumb attaches, your doctor may temporarily wire this joint into place, giving it a chance to heal without friction before removing the wire several weeks later.
  3. Joint Replacement: The most extensive of the surgeries, a full joint replacement is recommended if multiple structures in your thumb are damaged beyond repair.

What can you expect when you go in for surgery?

Most thumb surgeries are performed under local anesthetic and a sedative. In other words, you will be awake (although drowsy) during the procedure, but your arm will be numb. This reduces the risk of side effects in comparison to those associated with general anesthesia. You will usually be sent home later on the same day as your surgery. 

How long does recovery take?

It will take a little longer to recover from a joint replacement than from a ligament restructuring or a trapezium wiring. You can expect to be fully back in action 3 months post-surgery, or maybe 4 months after a full joint replacement. You'll need to wear a splint and a bandage to keep your thumb immobilized for a few weeks. Then, you'll start working with a physical therapist to slowly get the movement back in your thumb. Your pain should subside over time and should be manageable with over-the-counter pain relievers, in most cases.

If your thumb arthritis has started to interfere with your daily life, then it is time to take action. Talk to a local doctor about orthopedic surgery as a possible solution.