Which Thumb Arthritis Surgery Works Better: Implant or Ligament Repair?

If you have thumb arthritis, also called rhizarthrosis, you may be thinking about surgery. You are not alone. Many people face this choice. Two common surgeries are available. One uses a special implant called a pyrolytic carbon prosthesis. The other uses a technique where the surgeon removes damaged tissue and rebuilds the ligaments. But which one works better?

A study looked closely at both surgeries. Researchers followed 32 patients for about three years. They wanted to see which surgery helped people feel less pain and move their thumbs better. The results were surprising.

Here are three things you should know right away:

• The implant surgery caused more pain after a few years.
• The ligament repair surgery gave people better hand function.
• Six people with the implant needed another surgery to remove it.

What Is Rhizarthrosis and Why Does It Hurt?

Your thumb is important. You use it to hold things, turn keys, open jars, and write. When the base of your thumb hurts, simple tasks become hard. Many people feel frustrated. They want relief.

Some people try medicine, splints, or injections first. But when those do not work, surgery may be the next step. You may be wondering why this matters. The type of surgery you choose can affect how you feel years later.

What Are the Two Types of Surgery?

Doctors have two main ways to fix thumb arthritis with surgery. Let us look closer at each one.

The Implant Surgery

One surgery uses a special implant called a pyrolytic carbon prosthesis. The word prosthesis means an artificial part that replaces something in your body. This implant is a small disk made from a very hard material called pyrolytic carbon. The surgeon places this disk in your thumb joint. The idea is that the disk will act like a cushion between the bones.

The Ligament Repair Surgery

The other surgery is called ligamentous resection, suspension, and reconstruction. That is a long name. Here is what it means. The surgeon removes the damaged parts of the joint. Then the surgeon uses nearby tissue to create a cushion and rebuild support. Ligaments are strong bands that hold your joints together. This surgery rebuilds those supports without using an implant.

Here is where it gets interesting. Both surgeries try to fix the same problem. But they do it in very different ways.

How Did Researchers Compare These Surgeries?

According to this study, researchers looked at 32 patients. All of them had thumb arthritis. They were between 40 and 65 years old. Half of them got the implant surgery. The other half got the ligament repair surgery.

The surgeries happened between 2009 and 2013. Then in 2015, the researchers checked on all the patients. They asked about pain. They measured how well the thumb moved. They also asked patients to fill out a questionnaire about how well their hands worked in daily life.

The average time since surgery was 35 months. That is about three years. This gives us a good picture of how well each surgery works after the body has had time to heal.

Which Surgery Caused Less Pain?

Research shows that pain was much worse in the group with the implant. The study found a big difference. Patients who had the pyrolytic carbon implant felt more pain at the end of the follow up period.

This was a surprise to some doctors. They hoped the implant would protect the joint and reduce pain. But the results showed the opposite. The ligament repair surgery led to less pain over time.

Pain matters. It affects your sleep, your mood, and your daily life. Lower pain means you can do more of the things you love.

Which Surgery Gave Better Hand Function?

The researchers used a special test called the QuickDash questionnaire. This test asks people questions about daily activities. It gives a score. A lower score means better hand function.

According to this study, the implant group scored an average of 31 points. The ligament repair group scored an average of 16 points. Remember, lower is better. So the ligament repair group had better hand function.

The difference was clear. Patients who had ligament repair could do more things with their hands. They had less trouble with daily tasks.

Did One Surgery Allow Better Thumb Movement?

The researchers also measured how much the thumb could move. They looked at bending, stretching, and reaching.

Studies indicate that there was no big difference in movement between the two groups. Both surgeries allowed similar thumb motion at the end of follow up. This means that the type of surgery did not change how far you could move your thumb.

Movement is important. But if you have good movement and still feel pain or cannot do daily tasks, the surgery has not fully helped you.

What Problems Happened With the Implant?

This is a key finding. Six patients who got the implant needed another surgery. The implant had to be removed. That is 6 out of 16 people. That is more than one in three.

When an implant fails, it can cause more pain and swelling. The patient must go through another surgery. This means more time off work, more healing, and more worry.

The ligament repair surgery did not have this problem. None of those patients needed their surgery redone during the study period.

Common Questions

Is the implant surgery newer and better?

Not according to this research. The pyrolytic carbon implant was presented as a modern option. But studies show it did not work as well as the older ligament repair surgery. The implant caused more pain and led to more repeat surgeries.

How long does it take to recover from ligament repair surgery?

The study followed patients for about three years. Most healing happens in the first few months. But this research shows that after three years, patients who had ligament repair still felt better than those with the implant.

Will I be able to use my thumb normally after surgery?

According to medical evidence from this study, both surgeries allowed similar thumb movement. But the ligament repair group had better overall hand function. This means they could do daily tasks more easily.

What if my doctor recommends the implant?

You can ask your doctor about the research. Show them this study. Ask why they think the implant is right for you. You have the right to understand your options and make an informed choice.

What Does This Mean for You?

If you are thinking about surgery for thumb arthritis, this research gives you important information. The study shows that ligament repair surgery led to better results than the implant surgery.

Patients who had ligament repair felt less pain. They could do more with their hands. And they did not need repeat surgeries.

The implant may sound modern and appealing. But the results over three years were not as good. More than one in three patients needed the implant removed.

Talk to your doctor. Ask questions. Make sure you understand the risks and benefits of each surgery. This is your body. You deserve to know what works best.

Remember, every person is different. Your doctor knows your specific situation. But this research can help guide your conversation.

Important Information

This article is for educational purposes only. It is not medical advice. It does not replace the care and guidance of your doctor. Always talk to a qualified healthcare provider about your symptoms and treatment options. Every person is unique. What works for one person may not work for another. Use this information to ask better questions and have informed conversations with your medical team.

Research Source

This article is based on research published by Cuenca-Llavall, M., Lizano-Diez, X., Cruz-Sanchez, M., Cebamanos-Celma, J., and Pidemunt-Moli, G. in 2018.

https://doi.org/10.1016/j.recot.2018.01.002