If you have severe thumb arthritis at the base of your thumb, you may have heard about different types of surgery. You might be wondering which one gives the best results. Doctors have two main ways to fix this problem. Both methods remove a small bone and use a tendon to hold your thumb in place. But one method adds an extra piece of tendon and the other does not.
A recent study looked at 52 people with advanced thumb arthritis. All of them had surgery. Half got one type and half got the other. The study wanted to see which one worked better. Here are three key points:
- Both surgeries helped people feel better and use their thumbs more easily.
- The surgery without the extra tendon piece gave slightly better results.
- The surgery without the extra tendon was also faster to perform.
Key Findings at a Glance
- Research shows that 52 patients with severe thumb arthritis were treated with two different surgical techniques.
- The suspension tenoplasty without tendon interposition (Altissimi procedure) showed better DASH scores and range of motion compared to surgery with tendon interposition (Ceruso procedure).
- According to this study, surgical time was reduced by about 6 minutes when no tendon interposition was used.
- Both surgical methods provided good and satisfactory results for advanced basal joint arthritis.
- Studies indicate that the shift between thumb bones after surgery did not affect the final outcomes.
What Is Thumb Arthritis and Why Does It Hurt?
Thumb arthritis happens at the base of your thumb where it meets your wrist. This joint is called the carpometacarpal joint. When you use your thumb every day to grip things, pinch, or turn keys, this joint works hard. Over time, the cushion between the bones can wear away. This is called osteoarthritis.
When the arthritis gets very bad, doctors call it advanced arthritis. The study looked at people with grade III and grade IV arthritis. These are the most severe types. At this stage, simple treatments like medicine or splints may not help enough. Surgery becomes an option.
What Did This Study Look At?
Doctors wanted to know which surgery works best for people with severe thumb arthritis. They studied 52 people who all needed surgery. The same surgeon did all the operations. This made the comparison fair.
Here is where it gets interesting. The doctors split the patients into two equal groups. Each group got a different type of surgery. Then they watched how well people healed. They checked many things:
- How much pain people felt
- How well they could move their thumb
- How strong their grip and pinch were
- How easy it was to do daily tasks
- How the thumb looked on x-rays after surgery
They also timed how long each surgery took. This matters because shorter surgeries can mean less risk and faster recovery.
What Are the Two Surgeries?
Both surgeries start the same way. The surgeon removes a small bone at the base of the thumb. This bone is called the trapezium. Taking it out creates space. This stops the painful rubbing between bones.
Let us look closer at what happens next. This is where the two surgeries are different.
Surgery With Tendon Interposition (Ceruso Procedure)
In this method, the surgeon uses a tendon from your thumb called the abductor pollicis longus. The surgeon cuts a piece of this tendon. Then the surgeon places this piece into the empty space where the bone used to be. The tendon acts like a cushion. It also suspends your thumb in the right position. This is called suspension arthroplasty with tendon interposition.
Surgery Without Tendon Interposition (Altissimi Procedure)
In this method, the surgeon also removes the trapezium bone. But instead of adding an extra tendon piece, the surgeon uses a different tendon. This tendon is called the flexor carpi radialis. The surgeon wraps this tendon to create a sling that holds the thumb. No extra tendon piece is placed in the space. This is called suspension tenoplasty without tendon interposition.
You may be wondering why this matters. The first method adds an extra step and uses more tendon. The second method is simpler. But does simpler mean better?
What Were the Results?
According to this study, both surgeries helped people feel better. People had less pain. They could move their thumbs more easily. They could do more daily tasks.
Research shows that patients in both groups improved. The doctors measured improvement using several tools. One tool is called the DASH score. This measures how hard it is to do things with your hands and arms. A lower score means you can do more without trouble.
The doctors also checked range of motion. This means how far you can move your thumb in different directions. They tested pinch strength, which is how hard you can pinch something between your thumb and finger. They tested hand grip, which is how tightly you can squeeze your whole hand.
They took x-rays too. Sometimes after surgery, the thumb bones can shift a little bit. The doctors wanted to see if this shift made a difference. Studies indicate that the shift between the scaphoid bone and the base of the first metacarpal did not influence the final results. This means even if the bones moved a bit, people still got better.
Which Surgery Gave Better Results?
Both surgeries worked well. But the surgery without the extra tendon piece worked a little bit better. Here is what the numbers showed:
| Measurement | What It Means | Which Surgery Did Better? |
|---|---|---|
| DASH Score | Ability to do daily tasks | Altissimi (without extra tendon) |
| Range of Motion | How far the thumb can move | Altissimi (without extra tendon) |
| Surgical Time | How long the operation took | Altissimi (about 6 minutes faster) |
According to medical evidence, people who had the Altissimi procedure had better DASH scores. This difference was statistically significant. That means it was not just luck. The difference was real and meaningful.
The same was true for range of motion. People who had the surgery without the extra tendon could move their thumbs more freely.
The surgery was also faster. On average, it took about 6 minutes less time. This may not sound like much. But in surgery, every minute counts. Shorter surgery can mean less anesthesia, less stress on your body, and sometimes fewer complications.
Here is where it gets interesting. Even though the simpler surgery worked better, both surgeries were safe and helpful. No one had major problems. Everyone felt better than before surgery.
Frequently Asked Questions
What is suspension tenoplasty?
Suspension tenoplasty is a surgery where the doctor removes a worn out bone at the base of your thumb. Then the doctor uses a tendon from your wrist to create a sling. This sling holds your thumb in a good position. It keeps the bones from rubbing together. Some surgeons add an extra piece of tendon as a cushion. Others just use the sling without the extra piece.
How long does recovery take after thumb arthritis surgery?
The study does not give exact recovery times. But most people who have this type of surgery need several weeks to heal. You may wear a splint for a few weeks. Then you start gentle exercises. Full recovery can take several months. Your doctor will guide you through each step.
Will my thumb be as strong as before after surgery?
Research shows that both surgeries helped people improve their pinch strength and hand grip. Most people can do daily activities more easily after they heal. Your thumb may not feel exactly like it did before arthritis started. But it should feel much better than it did before surgery. You should have less pain and more movement.
Is one surgery safer than the other?
According to this study, both surgeries were safe. The same experienced surgeon did all the operations. Both groups of patients did well. The surgery without the extra tendon piece was a bit faster. Faster surgery can sometimes mean less risk. But both methods are considered safe and effective for treating advanced thumb arthritis.
What Does This Mean for You?
If you have severe thumb arthritis, you have options. Surgery can help you feel better and use your thumb more easily. This study shows that two different methods both work well.
Studies indicate that the simpler surgery, the one without the extra tendon piece, gave slightly better results. People had better function. They could move their thumbs more. The surgery was also faster.
But here is the important part. Every person is different. What works best for one person may not be exactly the same for another. Your doctor will look at your specific situation. They will consider your age, your activity level, and the exact condition of your thumb joint.
Talk to your doctor about these options. Ask questions. Learn about what each surgery involves. Find out what recovery looks like. Together, you can make the best choice for your thumb and your life.
We simplify medical science for people with thumb pain and rhizarthrosis. Every article on this site is based only on published scientific research. We read the studies so you do not have to. Then we explain what they mean in plain language. We invite you to explore more articles and learn about your options. Knowledge helps you make better decisions about your health.
Important Information
This article is for educational purposes only. It is not medical advice. It does not replace talking to your doctor. Only a qualified healthcare provider can diagnose your condition and recommend treatment. If you have thumb pain or arthritis, please see a doctor. They can examine you and suggest the best treatment for your specific situation.
Study Reference
This article is based on research by Fidanza, Andrea; Rovere, Giuseppe; Colafarina, Olivo; Chiarolanza, Fabrizio; Fulchignoni, Camillo; Smakaj, Amarildo; Liuzza, Francesco; Farsetti, Pasquale; Logroscino, Giandomenico, published in the Journal of Orthopaedics in 2024.
https://doi.org/10.1016/j.jor.2023.11.066
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