If you have thumb arthritis (also called rhizarthrosis), you know how much it can hurt to grip, pinch, or even move your thumb. You may have tried creams, splints, and medicine. But sometimes the pain does not go away. When that happens, surgery may be the next step.
Doctors wanted to find out which surgery works best. They looked at two different operations. One removes a small bone. The other replaces the joint with a new part. This study helps us understand which one might be better for you.
Key Findings at a Glance
- Both surgeries greatly reduced thumb pain after one year
- Patients who got a joint replacement had better daily function scores than those who had bone removal
- Pain scores dropped from 5 out of 10 to just 1 out of 10 in both groups
- Thumb movement improved in both groups, helping people use their hands again
- Two serious problems happened: one infection and one implant loosening
In this article:
- What is rhizarthrosis and why does it hurt?
- What are the two surgeries doctors compared?
- Who was in the study?
- What did the results show?
- What are the pros and cons of each surgery?
- Frequently Asked Questions
- Conclusion
- Disclaimer
- Study Citation
What is rhizarthrosis and why does it hurt?
Rhizarthrosis is a big word for arthritis at the base of your thumb. This is the joint where your thumb meets your wrist. Over time, the cushion inside the joint wears away. When that happens, the bones rub together. This rubbing causes pain, swelling, and stiffness.
Many people with this condition struggle to open jars, turn keys, or hold a pen. The pain can make everyday tasks very hard. You may have tried splints, exercises, or injections. But if those do not help, surgery may be an option.
What are the two surgeries doctors compared?
Doctors have several ways to fix thumb arthritis. This study looked at two popular surgeries.
Here is where it gets interesting.
The Burton-Pellegrini technique
This surgery removes a small bone called the trapezium. The trapezium is one of the small bones in your wrist near the base of your thumb. After the bone is removed, the surgeon uses a piece of your own tendon to fill the space. A tendon is a strong cord that connects muscle to bone. This tendon acts like a cushion and keeps your thumb stable.
Trapeziometacarpal joint replacement
This surgery replaces the worn joint with a new artificial part. Think of it like getting a new hinge for a door. The surgeon carefully removes the damaged surfaces of the joint. Then they put in a small metal and plastic implant. The implant is called a prosthesis. This new part moves like your old joint used to move when it was healthy.
You may be wondering why this matters. Each surgery has different benefits and risks. Let us look closer at what the research found.
Who was in the study?
According to this study, doctors followed 28 patients in total. Seventeen patients had the Burton-Pellegrini surgery. Most of them were men. Twelve of these patients had the problem in their dominant hand. That means the hand they use most for writing and daily tasks.
Eleven patients received the joint replacement. Ten were men and one was a woman. Seven had surgery on their dominant hand.
All of the patients had pain when they moved their thumb or gripped things. The doctors checked on them before surgery. Then they checked again at three months, six months, and one year after surgery.
What did the results show?
Research shows that both surgeries helped a lot. Pain went down. Movement got better. People could use their hands more easily.
Pain scores
Before surgery, patients rated their pain as 5 out of 10 on a scale called the visual analogue scale (VAS). This scale helps doctors measure how much something hurts. After one year, pain dropped to just 1 out of 10 in both groups. That is a huge improvement.
Thumb movement
Doctors used something called the Kapandji score to measure thumb movement. This test checks how far your thumb can reach across your hand. A higher score means better movement.
Patients who had the Burton-Pellegrini surgery went from a score of 6.4 before surgery to 8.9 after. Patients with the joint replacement went from 7.4 to 9.8. Both groups got better, but the joint replacement group scored a bit higher.
Daily activities
The doctors used a questionnaire called the DASH score. DASH stands for disabilities of the arm, shoulder, and hand. This score measures how hard it is to do daily tasks like dressing, cooking, or working.
Here is a table showing the results:
| Surgery Type | DASH Score Before | DASH Score After |
|---|---|---|
| Burton-Pellegrini (bone removal) | 58 points | 19 points |
| Joint Replacement | 56 points | 7 points |
A lower DASH score means less disability. Both groups improved, but the joint replacement group had better scores after surgery.
The study also looked at a special part of the DASH score that focuses only on thumb use. Before surgery, the Burton-Pellegrini group scored 63 points. After surgery, it dropped to 21 points. The joint replacement group went from 60 points to just 11 points. Again, the joint replacement group did better.
Problems and complications
Two serious problems happened. One patient in the Burton-Pellegrini group got an infection. One patient in the joint replacement group had trauma that caused the implant to loosen. Four patients had temporary numbness or tingling in their hand. This is called paresthesia. It went away on its own.
What are the pros and cons of each surgery?
Both surgeries have good points and not so good points. Let us break them down.
Burton-Pellegrini technique (bone removal with tendon)
Pros:
- Gives good pain relief
- Allows the thumb to move freely
- Uses your own tissue, so no artificial parts
Cons:
- Your thumb may be a little shorter after surgery
- You may lose some grip strength
- The tendon can tear if you use your hand too hard too soon
Joint replacement
Pros:
- Keeps the normal shape of your thumb
- Protects the ligaments and capsule around the joint
- Gives very good pain relief and function
- Preserves grip and pinch strength
Cons:
- The implant can loosen or dislocate
- Risk of infection with any artificial part
- You need good bone quality for the implant to stay in place
- Not everyone is a good candidate
According to this study, joint replacement gave slightly better results in daily function. But doctors must choose carefully. They need to make sure your bones are strong enough and the right size for an implant.
About This Site
This site helps people like you understand thumb pain and rhizarthrosis. We read published scientific articles and translate them into simple language. We only share facts from real research. We do not make things up. You can trust what you read here because it comes from doctors and scientists. We invite you to explore more articles to learn about your condition and your options.
Frequently Asked Questions
Which surgery is better for thumb arthritis?
Both the Burton-Pellegrini technique and joint replacement work well. According to this study, joint replacement gave slightly better results for daily activities and thumb function. But it is not right for everyone. Your doctor will look at your bone quality and the size of your bones to decide which surgery fits you best.
How long does it take to recover from thumb surgery?
This study checked on patients at three months, six months, and one year after surgery. Most people felt much better by one year. Your recovery time may be different. Ask your doctor what to expect.
Will I still have pain after surgery?
Research shows that pain dropped from 5 out of 10 to just 1 out of 10 one year after surgery in both groups. Most people feel much better. But every person is different. Some people may still have a little pain.
What are the risks of thumb surgery?
According to this study, serious problems included one infection and one implant loosening. Four patients had temporary numbness. Your doctor will explain all the risks before you decide.
Conclusion
If you have severe thumb arthritis that does not get better with other treatments, surgery may help. This study shows that both the Burton-Pellegrini technique and joint replacement can reduce pain and improve how you use your hand. Joint replacement gave slightly better results for daily activities, but it is not right for everyone.
Talk to your doctor about which option fits your situation. Ask about your bone quality, your activity level, and what to expect during recovery. You deserve to have less pain and more freedom to use your hands.
You are not alone in this. Many people find relief with the right surgery. Take your time to learn and ask questions. Your health is worth it.
Disclaimer
This article is for information only. It is not medical advice. Always talk to your doctor before making decisions about your health or treatment. Your doctor knows your situation best and can guide you to the right choice for you.
Study Citation
Authors: Jurca, J.; Nemejc, M.; Havlas, V.
Year: 2016
Publication: Acta Chir Orthop Traumatol Cech
Link: https://doi.org/10.55095/achot2016/004
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