Which Thumb Surgery Works Best for Arthritis Pain?

If you have thumb arthritis, you may have heard about different types of surgery. Doctors have many options to help your thumb feel better. But which one works best?

A new study looked at 21 different research papers to compare the most common surgeries for thumb arthritis. The researchers wanted to know which surgery gives the best pain relief, helps your thumb work better, and causes fewer problems.

Here are three key points from this study:

• All the surgeries helped with pain.
• One type of surgery called total joint replacement may help your thumb grip stronger.
• Simple surgeries worked just as well as more complicated ones for pain relief.

What is thumb arthritis?

Thumb arthritis is also called rhizarthrosis. It happens at the base of your thumb where two bones meet. This spot is called the trapeziometacarpal joint.

When the cushion inside this joint wears away, the bones rub together. This causes pain, swelling, and weakness. Simple tasks like opening a jar or turning a key can become very hard.

You may be wondering why this matters. Understanding where the problem is helps you understand why different surgeries work in different ways.

What did the study do?

According to this study published in the Journal of Hand Surgery Global Online in 2025, researchers gathered information from 21 different studies. All these studies looked at people who had surgery for thumb arthritis.

The researchers compared different types of surgery. They wanted to see which one gave the best results. They looked at pain levels, how well people could use their hands, how strong their thumb grip was, and whether people had problems after surgery.

This type of research is called a network meta analysis. It is a way to compare many treatments at once, even if they were never tested against each other directly.

Here is where it gets interesting. The study found some surprising results.

What are the surgery choices?

Doctors use several different surgeries for thumb arthritis. Let us look at the main ones.

Simple trapeziectomy

In this surgery, the doctor removes one small bone called the trapezium. This bone is shaped like a trapezoid and sits at the base of your thumb. When it is gone, the pain from bone rubbing on bone goes away.

Trapeziectomy with LRTI

This is a longer name for a more complicated surgery. LRTI stands for ligament reconstruction and tendon interposition.

Many surgeons thought this extra step would give better results. But does it really?

Total joint arthroplasty

This is the medical term for joint replacement. The surgeon removes the damaged joint and puts in an artificial one made of metal or plastic.

This keeps the space between bones and may help the thumb stay stronger.

Which surgery worked best for pain?

Research shows that all the surgeries helped reduce pain. When doctors compared simple trapeziectomy to the more complicated trapeziectomy with LRTI, the pain relief was almost exactly the same.

The study used a pain scale where people rated their pain from zero to ten. The difference between the two surgeries was only 0.22 points. That is such a tiny difference that patients would not even notice it.

Let us look closer. What about joint replacement?

Studies indicate that total joint replacement also gave similar pain relief compared to removing the bone. The difference was 0.20 points on the pain scale. Again, this is too small for you to feel in real life.

The researchers rated this finding as moderate certainty. This means they feel fairly confident that the results are true.

What about thumb strength?

According to this study, thumb strength showed more interesting differences. Researchers measured something called key pinch strength. This is how hard you can pinch your thumb and pointer finger together, like when you hold a key to unlock a door.

When simple trapeziectomy was compared to trapeziectomy with LRTI, the key pinch strength was nearly the same. The difference was only 0.07 kilograms.

But here is where joint replacement stood out. Research shows that people who had total joint replacement had stronger key pinch than people who had bone removal surgery. The difference was 0.92 kilograms.

This difference was large enough that you would actually notice it in daily life. The researchers called this clinically significant, which means it matters to real patients doing real tasks.

Joint replacement also ranked first when all surgeries were compared together in the network analysis. However, the advantage was only clear and certain for strength, not for pain or function.

What about problems after surgery?

Every surgery carries some risk of complications. Complications are problems that happen during or after surgery, like infection, poor healing, or the need for another surgery.

Studies indicate that complication rates were similar between simple trapeziectomy and the more complicated version with LRTI. They were also similar between bone removal and joint replacement, at least in the short term.

But there is an important limitation here. The study only looked at short term results, mostly within the first year or two after surgery. We do not yet have good long term information about joint replacements in the thumb.

You may be wondering why this matters. Joint replacements in other parts of the body, like hips and knees, can wear out over time. Some need to be replaced again after 10 or 20 years. We do not yet know if thumb joint replacements will last that long or if they might cause problems later.

Common questions

Should I choose the simpler or more complicated surgery?

According to this study, simple trapeziectomy works just as well as trapeziectomy with LRTI for pain relief, hand function, and thumb strength. The simpler surgery may mean shorter operation time and possibly faster recovery. Talk with your surgeon about what makes sense for your situation.

Is joint replacement better than bone removal?

Research shows that joint replacement may give you stronger thumb pinch strength compared to removing the bone. The pain relief is similar between the two. However, we do not have enough long term safety information yet. Your surgeon can help you weigh the benefits against the unknowns.

How long do the results last?

This study looked at short term results, mostly within one to two years after surgery. Studies indicate that pain relief and improved function continue in that time frame. Longer studies are needed to know how well these surgeries work after five, ten, or twenty years.

What if I am worried about complications?

Studies indicate that complication rates are similar between simple and more complex surgeries in the short term. Your individual risk depends on many factors including your overall health, your age, and your surgeon’s experience. Have an honest conversation with your doctor about what to expect.

What does this mean for you?

If you are facing surgery for thumb arthritis, this research gives you helpful information. All the common surgeries can reduce your pain. The simpler surgeries work just as well as the more complicated ones for most outcomes.

Total joint replacement may help your thumb stay stronger, especially for pinching tasks. But we still need more research about how these implants hold up over many years.

The good news is that you have options. Talk with your hand surgeon about your goals, your lifestyle, and what matters most to you. Together you can choose the surgery that fits your needs.

Remember, this study compared surgeries for people who already decided to have an operation. Many people with thumb arthritis get better with treatments that do not involve surgery, like splints, exercises, or injections. Always explore those options first.

About this site

This website helps people with thumb pain and rhizarthrosis by breaking down complex medical research into simple language. We only use information from published scientific articles. Nothing is made up or guessed. Every fact comes from real studies done by real researchers. We invite you to explore more articles on this site to learn about your condition and your treatment choices.

Disclaimer

This article is for information only. It is not medical advice. It does not replace talking with your doctor. Every person is different. What works for one person may not work for another. Always discuss your symptoms and treatment options with a qualified healthcare professional before making any decisions about your care.

Source

Study citation: Challoumas, Dimitris; Hamad, Ali; Rana, Varun; Putti, Amit; Millar, Neal L. (2025). Surgery for Trapeziometacarpal Joint Arthritis: A Network Meta-Analysis of Randomized Studies. Journal of Hand Surgery Global Online.

https://doi.org/10.1016/j.jhsg.2025.100737