If you have pain at the base of your thumb, you are not alone. Many people face this problem. Doctors call it thumb carpometacarpal osteoarthritis. That is a big word that means the joint at the base of your thumb is wearing out. When pain does not go away with simple treatments, surgery may help. But which surgery is best?
Researchers looked at two different surgeries for thumb arthritis. One uses a small artificial joint. The other removes a bone and uses a tendon from your body to help support your thumb. Both are common. But which one helps you feel better faster?
Key Findings at a Glance
- According to this study, patients who received a double mobility thumb prosthesis had less pain and better function at 6 weeks after surgery compared to the Epping resection-suspension arthroplasty.
- Research shows that by 6 months and 1 year after surgery, both procedures resulted in similar pain relief and hand function with no significant differences.
- Studies indicate that 3 out of 82 thumb prostheses required revision surgery during the follow-up period, while no patients in the Epping group needed revision.
- Medical evidence shows the implant survival rate was 96% after 12 months, which doctors consider acceptable.
- This randomized controlled trial included 183 cases of thumb carpometacarpal osteoarthritis over a 7-year period.
In this article:
- What is thumb carpometacarpal arthritis?
- What are the two surgeries doctors compared?
- How did the researchers study these surgeries?
- What did they find in the first weeks?
- What happened after 6 months and 1 year?
- Were there any problems?
- Frequently Asked Questions
- What does this mean for you?
- Disclaimer
- Study Source
What is thumb carpometacarpal arthritis?
Your thumb has a special joint at its base. This joint lets you move your thumb away from your hand. It also lets you pinch and grip things. Over time, the smooth surface inside this joint can wear down. When that happens, bone rubs on bone. This causes pain. It also makes it hard to open jars, turn keys, or hold a pen.
Many people with this condition try splints, medicine, or injections first. But sometimes those treatments do not help enough. That is when surgery becomes an option.
What are the two surgeries doctors compared?
You may be wondering which surgery is right for you. Doctors have many choices. This study looked at two popular ones.
The first surgery is called the Epping resection-suspension arthroplasty. That sounds complicated. Let us break it down. In this surgery, the doctor removes a small bone at the base of your thumb. Then the doctor uses one of your own tendons to create a cushion. A tendon is like a strong cord that connects muscle to bone. This tendon acts like a hammock to support your thumb. Your body does not reject it because it comes from you.
The second surgery uses a double mobility thumb prosthesis. A prosthesis is an artificial part that replaces something in your body. In this case, it is a small artificial joint. This one is special because it has two parts that move. That gives your thumb more natural motion. The brand used in this study was called Moovis, made by Stryker.
Both surgeries aim to reduce pain and help you use your thumb again. But they work in different ways.
How did the researchers study these surgeries?
According to this study, researchers followed 183 cases of thumb arthritis over 7 years. That is a long time. That is also a lot of patients. This kind of study is called a randomized controlled trial. That means patients were put into groups by chance. This helps make the results fair.
Here is where it gets interesting. The researchers measured many things before and after surgery. They looked at how much the thumb could move. They asked patients about their pain. They also asked about daily activities like dressing, cooking, and working. They used special questionnaires to track all of this.
One questionnaire was called the DASH score. DASH stands for disabilities of the arm, shoulder and hand. A higher score means more difficulty doing everyday tasks. They also used a pain scale called VAS. VAS stands for visual analogue scale. Patients rate their pain from 0 to 10. Zero means no pain. Ten means the worst pain imaginable.
The researchers checked on patients at 6 weeks, 6 months, and 1 year after surgery. This gave them a clear picture of how each surgery worked over time.
What did they find in the first weeks?
At 6 weeks after surgery, the prosthesis group was doing better. Let us look at the numbers.
Research shows that patients with the prosthesis had less pain. Their median pain score was 2.0. Median means the middle number when you line up all the scores. The Epping group had a median pain score of 4.0. That difference was significant. In science, significant means it probably did not happen by chance.
The prosthesis group also had better function. Their DASH score was 45. Remember, lower is better for this score. The Epping group had a DASH score of 61. That means they had more trouble with daily tasks.
The prosthesis group could also move their thumbs further away from their hands. Doctors call this radial abduction. The prosthesis group could move their thumbs to 62 degrees. The Epping group could only reach 55 degrees.
| Measurement | Prosthesis Group | Epping Group |
|---|---|---|
| Pain Score (VAS) | 2.0 | 4.0 |
| DASH Score | 45 | 61 |
| Radial Abduction (degrees) | 62 | 55 |
These results suggest that the prosthesis helps you recover faster in the first few weeks.
What happened after 6 months and 1 year?
Let us look closer at the longer term results. By 6 months after surgery, something interesting happened. The two groups looked much more similar. The Epping group had caught up. Their pain was now about the same as the prosthesis group. Their function scores were similar too.
Medical evidence shows that at the 1 year mark, there were still no significant differences between the groups. Both surgeries gave good results. Patients in both groups had less pain than before surgery. They could do more with their hands. Their quality of life improved.
This tells us something important. While the prosthesis helps you feel better faster, both surgeries work well after you have fully healed.
Were there any problems?
No surgery is perfect. Sometimes things go wrong. In this study, 3 of the 82 prostheses had to be revised. Revised means the doctors had to do another surgery to fix or replace the prosthesis. That is about 4 out of every 100 prostheses.
In the Epping group, no one needed a second surgery during the study period. That is a good sign. It means the tendon suspension held up well.
Studies indicate the implant survival rate was 96% after 12 months. Survival rate means the prosthesis was still working without problems. The researchers said this rate was acceptable. But it is something to think about if you are choosing between surgeries.
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We know medical research can feel confusing. That is why this site exists. We read the scientific articles so you do not have to. We explain thumb pain and rhizarthrosis using only real published studies. No guesses. No opinions. Just facts from medical journals, written in words you can understand. We invite you to explore more articles on this site. Each one breaks down the science to help you make informed choices about your health.
Frequently Asked Questions
Which surgery is better for thumb arthritis?
According to this study, the double mobility prosthesis gives faster pain relief and better function in the first 6 weeks after surgery. However, by 6 months and 1 year, both the prosthesis and the Epping resection-suspension arthroplasty show similar results. Your doctor can help you choose based on your specific situation.
Will I need another surgery if I get a thumb prosthesis?
Research shows that 3 out of 82 prostheses in this study needed revision surgery during the follow-up period. That means about 96% of the prostheses were still working well after 1 year. Most patients do not need a second surgery, but it is a possibility to discuss with your surgeon.
How long does it take to recover from thumb arthritis surgery?
Medical evidence from this study shows that patients see the biggest improvements in the first 6 months after surgery. The prosthesis group had less pain and better function at 6 weeks. The Epping group caught up by 6 months. Full recovery varies for each person, but most patients notice significant improvement within the first year.
What is the Epping procedure?
The Epping resection-suspension arthroplasty is a surgery where the doctor removes a small bone at the base of your thumb and uses one of your own tendons to support the joint. According to this study, it has no revision surgeries during the follow-up period and gives good long term results similar to a prosthesis.
What does this mean for you?
If you are living with thumb pain, you have options. This study gives you real information to discuss with your doctor. The prosthesis may help you feel better faster. But the Epping procedure also works well and may have a lower chance of needing a second surgery.
Both surgeries can reduce pain and help you use your thumb again. The best choice depends on your age, your activity level, and what matters most to you. Do you want the fastest recovery? Or do you prefer a surgery that uses your own tissue?
Talk to your hand surgeon. Ask questions. Share what you learned here. Together, you can make the right choice for your life.
Disclaimer
This article is for informational purposes only. It is not medical advice. It does not replace a conversation with your doctor. Every person is different. Your doctor knows your medical history and can give you personalized guidance. If you have thumb pain, please see a qualified healthcare professional for diagnosis and treatment options.
Study Source
Klim, Sebastian M.; Glehr, Reingard; Graef, Armin; Amerstorfer, Florian; Leithner, Andreas; Glehr, Mathias (2023). Total joint arthroplasty versus resection-interposition arthroplasty for thumb carpometacarpal arthritis: a randomized controlled trial. Acta Orthopaedica.
https://doi.org/10.2340/17453674.2023.11919
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