Osteoarthritis of the thumb base joint

Osteoarthritis of the thumb is also called rhizarthrosis. The condition affects the joint at the base of the thumb, which is located between the metacarpal bone of the thumb and the bones of the wrist. It is one of the most common forms of osteoarthritis in the hand and can cause significant problems in daily life. Women are affected more than men.

What are the symptoms?

The most common symptoms are:

• Over time, you may experience resting pain, reduced mobility, misalignment of the thumb and reduced strength
• You may experience pain and swelling around the base joint of the thumb
• The pain manifests itself especially when you use a power grip between the thumb and the other fingers, for example when you wring out a cloth or open a screw cap
  
  

How do we treat osteoarthritis of the thumb?

With milder symptoms, surgery is rarely necessary. You can get good relief with a supportive splint, pain-relieving medication, exercises that strengthen the muscles or an injection with corticosteroid. If the pain worsens, surgery is usually a good and pain-relieving treatment. In addition, the function of the thumb is also improved.

Surgery

When surgery becomes necessary, there are two most commonly used options:

• Trapeziectomy with interposition arthroplasty.
  The bone called the trapezium is removed. This bone forms one part of the base joint. Subsequently, stabilisation is performed with the joint capsule or with part of a nearby tendon. For the first 3-4 weeks, the thumb and wrist must be in a cast.
  
  After that, training via an occupational therapist is needed.
  Many patients get a very good result with good pain relief, but the rehabilitation time is often up to ½ year before the thumb functions satisfactorily.
  
  The thumb often becomes slightly shorter. This can affect the function of the thumb in the future. In addition, there is often a temporary change in sensation on the dorsal side, this can last up to ½ year. In some cases, further shortening of the thumb may occur over time, which can cause new pain.
  
  
• Prosthesis operation (insertion of artificial joint)
  During a prosthesis operation, an uncemented prosthesis made of metal and plastic is inserted. The prosthesis replaces the basal joint of the thumb and resembles a miniature version of a hip prosthesis. To benefit from this method, there must be good bone quality, and there must be no problems with the other joints of the thumb. The operation is completed with a cast for 2 weeks on the thumb and wrist, after which it is important that subsequent training takes place via an occupational therapist.
  
  There is often a temporary change in sensation on the dorsal side; this can last up to ½ year.
  Most patients achieve good mobility as early as 6 weeks after the operation and good pain relief after 3 months with good function and strength of the thumb.
  
  As with operations involving prostheses in other joints, e.g. hip and knee, there is a risk of wear or mechanical failure, which may mean that the prosthesis will need to be replaced or removed in the long term. An interposition arthroplasty may then be considered.
  
  Experience with the latest prosthesis designs is very good. Studies show that around 95% of prostheses are functioning after five years, and the results approach those seen after insertion of hip and knee prostheses

Safe and rapid clarification

At CPH Privathospital, we have consultant specialists with extensive experience in hand surgery and thus in the treatment of osteoarthritis of the thumb.

Our consultant specialists are ready to help you so that you can quickly receive the correct diagnosis – whether you are a private payer, have health insurance or come through the public waiting time guarantee.

All examinations and treatments can take place at CPH Privathospital, and you will see the same experienced consultant specialist throughout your entire pathway.