Can Thumb Joint Replacement Really Fix My Arthritis Pain?

If you have been living with pain at the base of your thumb, you know how hard it can be to do simple things. Opening a jar, turning a key, or even holding a pen can hurt. When other treatments stop working, doctors sometimes suggest a thumb joint replacement. But does it really help?

In this article, we share what recent medical research tells us about thumb joint replacement surgery. We look at a special type of replacement called the Maia prosthesis. We explain how well it works, what problems can happen, and how people feel after the surgery.

Here are three things you will learn:

• What thumb joint replacement is and who needs it.
• How well people move their thumbs and how strong their grip becomes after surgery.
• What complications can happen and how often the replacement lasts.

What is thumb arthritis and why does it hurt?

Thumb arthritis happens at the base of your thumb. This is where your thumb bone meets a small bone in your wrist. Doctors call this the trapeziometacarpal joint, or TMC joint for short. When the smooth coating on these bones wears away, the bones rub together. This causes pain, swelling, and stiffness.

Doctors use something called the Eaton-Littler classification to describe how bad the arthritis is. This system goes from grade I, which is mild, to grade IV, which is severe. Most people who need surgery have grade II or grade III arthritis.

What is thumb joint replacement?

When pain medicine, splints, and injections no longer help, surgery becomes an option. One type of surgery is called thumb joint replacement or arthroplasty. This means the doctor removes the damaged joint and puts in an artificial one made of metal and plastic.

The Maia prosthesis is one type of artificial joint. It has two parts. One part fits into the wrist bone called the trapezium. The other part fits into the thumb bone called the metacarpal. These parts work together like a ball and socket so your thumb can move.

You may be wondering why this matters. If the artificial joint works well, you can use your hand again without pain.

Who was studied in this research?

According to this study published in 2024, researchers looked at 22 patients who had thumb joint replacement surgery between 2015 and 2017. Almost all of them were women. There was only one man. The average age was about 60 years old.

Most of these patients had grade III arthritis. That means their arthritis was quite advanced. Four patients had grade II arthritis. All of them had tried other treatments first, but those treatments did not work anymore.

The researchers followed these patients for an average of about 56 months. That is almost five years. This gives us a good picture of how well the replacement works over time.

How well did people move their thumbs after surgery?

Research shows that thumb movement improved a lot after surgery. Doctors measure thumb movement in different ways. One way is called radial abduction. This is how far you can move your thumb away from your hand to the side.

Studies indicate that the average thumb movement was about 89% of what the other hand could do. That is very close to normal. Most people could move their thumbs almost as well as before they had arthritis.

Doctors also use something called the Kapandji score. This measures how well you can touch different parts of your hand with your thumb. The score goes from 0 to 10. According to medical evidence, the average score was 9.5 out of 10. This is 98% of what the other hand could do.

Here is where it gets interesting. These results mean that most people got back almost all of their thumb movement.

How strong were their hands after surgery?

Getting your strength back is important too. You need strength to hold things, open jars, and do daily tasks. The study looked at two types of strength.

The first is called key pinch. This is when you pinch something between your thumb and the side of your index finger, like holding a key. Research shows that the average key pinch strength was 4.7 kilograms. This was about 79% of the strength in the other hand.

The second is grip strength. This is how hard you can squeeze your whole hand closed. Studies indicate that the average grip strength was 8 kilograms. This was about 81% of the other hand.

Let us look closer. While these numbers are not 100%, they are still quite good. Most people could do their daily activities much better than before surgery.

Were patients happy with their results?

Doctors asked patients to rate how happy they were with the surgery on a scale from 0 to 10. According to this study, the average satisfaction score was 8.8 out of 10. That is very high. It means most people were very pleased with their results.

The researchers also used a questionnaire called the qDASH score. This stands for Quick Disabilities of the Arm, Shoulder, and Hand. It asks patients how hard it is to do everyday tasks. A lower score is better. The average score was 25.8. While this shows some difficulty remains, it is much better than before surgery when pain made tasks nearly impossible.

What problems can happen?

Like any surgery, thumb joint replacement can have problems. Medical evidence shows that 13.6% of patients needed another surgery. That is about 3 out of 22 people.

Two patients had dislocations. This means the artificial joint parts came apart. One patient had loosening of the trapezium cup. This is the part that fits into the wrist bone. When it loosens, it does not stay in place properly.

The good news is that there were no infections. Infection is always a risk with surgery, but it did not happen to anyone in this study.

Research shows that the survival rate of the implant was 86.4% after five years. This means that about 86 out of 100 implants were still working well without needing replacement or removal.

The researchers noted that this surgery has a learning curve. This means it takes practice for surgeons to get really good at it. As doctors do more of these surgeries, results may get even better.

Common Questions About Thumb Joint Replacement

What does this mean for you?

If you have been struggling with thumb pain that does not get better with other treatments, thumb joint replacement might be worth talking about with your doctor. According to this study, most people who had this surgery were very happy with their results. They got back most of their thumb movement and strength. They could do daily tasks that had become too painful before.

The surgery does have some risks. About 1 in 7 people needed another surgery to fix a problem. But most implants lasted at least five years without issues.

Remember that every person is different. What worked well for these patients might not be exactly the same for you. The best thing to do is talk with a hand surgeon who has experience with this type of surgery. They can look at your specific situation and help you make the right choice.

You do not have to live with thumb pain forever. There are options that can help.

Important Information

This article is for educational purposes only. It is not medical advice. It does not replace talking with your doctor. Every person’s health situation is different. Always talk with a qualified healthcare provider about your symptoms and treatment options. Do not make medical decisions based only on what you read online.

Scientific Source

Study Citation: Correia, G.; Ribeiro, E.; Correia, R.; Ribau, M.; Varanda, P.; Ribeiro, J.; Rodrigues, L. F. (2024). Trapeziometacarpal Joint Arthroplasty: Medium-Term Clinical Outcomes and Survival. Cureus.

Read the full study here:
https://doi.org/10.7759/cureus.72888