Thumb Arthritis

WHAT YOU SHOULD KNOW

The term arthritis simply refers to the condition of a joint losing its smooth cartilage surface. When this happens the two bones that make up the joint begin to contact each other. This friction and grinding causes pain, swelling, stiffness and further cartilage loss.Osteoarthritis has no special cause other than use of the joint for many years throughout life. Other types of arthritis are special inflammatory conditions such as rheumatoid arthritis or post-traumatic damage to the joint causing arthritis.

MEDICAL HISTORY

The symptoms usually set in slowly over time. Eventually patients complain of lost function, pain, stiffness, swelling, weakness, and sometimes deformity. The doctor will ask questions to determine whether the arthritis is post-traumatic, osteoarthritis, or a special inflammatory arthritis.

EXAMINATION

The joints are tested for range of motion, stability, alignment, and any grinding during movement.

ADDITIONAL TESTS

Plain x-rays show the degree of arthritis and any bone loss or erosion that may have happened.

TREATMENT OPTIONS

Suspension

Prosthesis

  NON-OPERATIVE SUSPENSION PROSTHESIS
CONSISTS OF Oral pain medications, cortisone injections Removal of the small bone under the thumb; tendon used to suspend thumb from collapsing Prosthesis replaces the damaged joint surface at base of the thumb; keep the small bone underneath
FEATURES Limited number of injections is allowed Rearrangement of the joint using only the body’s own tissues Smooth surface of the prosthesis replaces one side of the joint
ADVANTAGES Avoids surgery Result is durable for over a decade Solid support for the thumb, joint contact surfaces control thumb position
DISADVANTAGES Only treats the symptoms, not the underlying bone contact Lose direct bony support for thumb, no actual joint to control movement Long-term results are not known as this is a new treatment
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RECOVERY

No sutures to be removed, below skin dissolvable. Initial splinting protects both the suspension and prosthesis procedures. No forceful pinch to thumb with either procedure in first 6 weeks. Motion started in the rest of the hand right away. Motion at the operated joint begins at 2 weeks for the prosthesis and 5 weeks for the suspension. Splint is discontinued entirely by 6 weeks for the prosthesis and 10 weeks for the suspension. Strengthening is an ongoing process after.

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