Thumb CMC Arthritis
What is thumb CMC arthritis?
Thumb arthritis is one of the most common arthritis conditions seen in the upper extremity. The joint involved is the carpometacarpal joint (CMC), which is at the base of the thumb.
How does thumb CMC arthritis occur?
This arthritis is most typically seen between the ages of 40-60 and is more common in women. Younger people and men can also develop CMC arthritis and the this may be due to previous trauma or repetitive activity. The thumb CMC joint is described as a “saddle” joint because of its shape. Normally, the thumb metacarpal sits nicely in the saddle. Through ligament injury, overuse or for genetic reasons, the thumb metacarpal may slide partially out of the saddle joint resulting in
Diagnosing thumb CMC arthritis
Thumb CMC arthritis can interfere with activities of daily living. Things like opening jars, forcefully pinch and lifting activities can result in pain and weakness. Some patients report aching and soreness that can keep them awake at night.
Non-surgical treatment of thumb CMC arthritis
Treatment for thumb CMC arthritis is like arthritis elsewhere in the body. Conservative treatment consists of rest, splint immobilization, anti-inflammatory, therapy, cortisone injections and biological injections. Therapy can help build the muscles around the thumb and help strengthen the joint. Cortisone injections can temporarily help with the pain. Platelet Rich Plasma (PRP) is a treatment where a patient’s own blood is drawn, and the platelets are concentrated via centrifuge to isolate Platelet Derived Growth Factor which can help in tissue healing. Favorable results have been reported in some patients.
Surgically treating thumb CMC arthritis
Surgical reconstruction is a highly successful treatment for thumb CMC arthritis. Various techniques can be used and are patient dependent. The most common reconstructive technique we use is a CMC suspensionplasty. In this technique, the arthritic bone is removed, and tendons are used to “suspend” and reconstruct the joint. Unlike the LRTI (anchovy) technique, the tendons are not removed, and no drill holes are used allowing for faster recovery.
Various implant designs are available, and we sometimes chose these for certain patients. Metal implants have had some success although the long-term results are not yet known. The Speed Spiral is a soft tissue implant that allows for better pinch and grip in high demand patients with good short-term results.
Recovering from thumb CMC arthritis surgery
After surgery, patients are placed in either a splint or cast for up to 4 weeks. The splint or cast covers the thumb and wrist but not the fingers so the hand remains functional. The patient then starts therapy to build strength for 1-2 months and most activities can be resumed by 3 months after surgery.
Overall, the results of CMC implant arthroplasty are very good and its rare that additional surgery is necessary. Most patients can resume their normal activities with minimal pain and good strength.
Schedule a consultation
Board-certified and fellowship-trained hand surgeon Dr. Kavi Sachar is widely regarded as one the nation’s leading experts on thumb arthritis. Dr. Sachar has three office locations in Vail, Aspen, and Frisco, Colorado. If you or a family member suffer from thumb arthritis, contact Sachar today. Dr. Sachar is part of the world-renowned Steadman Clinic. Dr. Sachar and his team are here to help.
At a Glance
Dr. Kavi Sachar
- Specializing in Hand, Wrist, & Elbow Surgery
- Board Certified Orthopedic & Hand Surgeon
- Consultant to the US Ski & Snowboard Team & Colorado Avalanche
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