What is thumb base arthrosis?
Thumb base refers to the base joint of the thumb. This is the joint formed by the metacarpal bone of the thumb and the saddle-shaped bone (trapezium). Wear and tear on this joint is also called rhizarthrosis or CMC-1 arthrosis.
In osteoarthritis, joint cartilage is affected. Cartilage is smooth tissue at the end of bones that allows the bones in a joint to move smoothly in relation to each other. Cartilage can become thin and eventually disappear altogether; this is called arthrosis. When cartilage becomes thin, or bone meets bone, the mobility of the joint decreases. Pressure on the underlying bone also increases. To better distribute the pressure over the joint surface, bone formation may occur at the edges of the joint, causing the joint to thicken. In addition, inflammation of the inner lining of the joint (synovitis) develops which can cause symptoms of pain, swelling and heat.
What are the symptoms in thumb base arthrosis?
Complaints consistent with wear and tear of the base of the thumb are pain, swelling and warmth. Pain symptoms often increase when straining the joint, such as when holding tweezers, picking up heavier objects, opening jars, wringing out cloths. Loading the joint also often decreases, causing a feeling of loss of strength. The joint may change shape. Sometimes the thumb cannot move as well to the side, making it harder to open the hand.
Diagnosis
Based on the pattern of symptoms and physical examination, the diagnosis is made. Additional X-rays are taken to determine the severity of the wear and tear.
Once the diagnosis of thumb base arthrosis is finalized, a treatment plan will be developed depending on the severity of the symptoms and the patient's overall condition.
Treatment:
Non-operative (conservative) treatment
A joint with wear often responds more strongly to load. The goal of conservative treatment is to rest the joint and ensure that the synovitis subsides.
Wearing a brace (splint) around the base of the thumb gives the joint support and thereby rest. Adjusting or performing daily activities differently can also improve symptoms. The hand therapist can provide guidance in this regard. Performing a specific exercise program of the thumb muscles can also reduce pain. In most cases, this conservative therapy is sufficiently effective and does not require surgery.
The use of painkillers such as paracetamol and anti-inflammatories (only if the patient's overall condition allows) can reduce pain symptoms.
If the above therapy is insufficient, an injection into the joint with corticosteroids may be considered. Often the treatment effect of this is temporary.
Surgical treatment
If all conservative options have been gone through and were not sufficiently effective, surgical treatment may be chosen. Surgery is done in day surgery. The entire arm is numbed by a nerve block or general anesthesia is used. There are several surgical options. In our clinic, part of the affected joint is removed (the trapezium) so that the arthrosis pain disappears. After this, a tendon from the forearm is used to stabilize the metacarpal bone and refill the remaining space. The wound is sutured with stitches that can be removed after 10-14 days Flex Clinics is part of MSB Flex Coöperatie U.A.
Becoming. After surgery, you will have a pressure bandage for 10-14 days. You should take it easy for the first 6 weeks after surgery. During the consultation hour, you will receive detailed information about post-surgery treatment and recovery, and you will be given an information brochure about the procedure.
