Which Surgery Works Best for Thumb Arthritis at the Base?

If you have pain at the base of your thumb, you are not alone. Thumb arthritis at the base joint is very common. Doctors call this rhizarthrosis or rhizarthritis. When other treatments do not help, surgery can be an option. But which kind of surgery works best?

Researchers compared two different surgeries for thumb arthritis. They wanted to see which one gave better results. They looked at 72 patients who had surgery between 2001 and 2008.

Here are three important things they found:

• Both surgeries helped more than 80 out of 100 patients feel much better
• Patients were equally happy with either type of surgery
• Each surgery has its own benefits and challenges

What Is Rhizarthritis and Who Gets It?

Rhizarthritis is very common. According to this study, it affects about 10 out of every 100 people. That makes it the most common type of arthritis in the hand. Many people try treatments like splints or medicine first. But when these do not work well enough, surgery can help.

You may be wondering why this matters.

When your thumb hurts all the time, simple tasks become hard. Opening jars, turning keys, or holding a pen can cause pain. Finding the right surgery can give you back the use of your thumb.

What Are the Two Surgery Options?

The researchers looked at two different ways to fix thumb arthritis with surgery. Let us look closer at each one.

The Epping Procedure

The first surgery is called resection suspension arthroplasty according to Epping. That is a long name. In simple words, the surgeon removes a small bone at the base of your thumb. This bone is called the trapezium. Then the surgeon uses your own ligament to hold the thumb in place. A ligament is like a strong rope inside your body that connects bones.

This surgery has been used for many years. Doctors know it works well.

The Pyrocarbon Spacer Surgery

The second surgery also removes the trapezium bone. But instead of just using a ligament, the surgeon puts in a special spacer. This spacer is made of pyrocarbon. Pyrocarbon is a strong material that the body usually accepts well. The spacer takes the place of the bone that was removed.

Here is where it gets interesting.

The spacer allows the thumb to move in many directions. It can also handle weight and pressure. This sounds like a good thing. But it is newer than the Epping procedure. That means doctors have less experience with it over a long time.

How Did Researchers Compare These Surgeries?

Research shows that between January 2001 and December 2008, doctors treated 84 patients for thumb arthritis at one clinic. Of these patients, 12 had other types of surgery. That left 72 patients in two groups.

Here is how the groups were divided:

The researchers looked back at the medical records. This is called a retrospective study. They checked how well each patient did after surgery. They used something called the Buck Gramcko criteria. This is a scoring system that measures how well the thumb works and how much pain the patient has.

What Did the Study Find?

According to this study, both surgeries worked very well. More than 80 out of every 100 patients got very good or good results. This was true for both the Epping procedure and the pyrocarbon spacer surgery.

Patients were equally happy with both surgeries. They had the same level of satisfaction. This is important because it means both options can help reduce pain and improve thumb function.

You may be wondering why this matters.

When you are choosing a surgery, you want to know it will work. These results show that both surgeries have a good chance of helping you feel better.

What Are the Good and Bad Points of Each Surgery?

Benefits of the Epping Procedure

Studies indicate that the Epping procedure has been used successfully for many years. Doctors know how to do it well. It uses your own body tissue, so there is no foreign material left inside except for the sutures that hold things together.

The study confirms that this surgery is valuable for treating thumb arthritis. It gave good results for the patients in this research.

Challenges with the Pyrocarbon Spacer

The pyrocarbon spacer surgery also gave good results. Medical evidence suggests that in the majority of cases, patients got good or very good outcomes. The spacer allows the thumb to move well in many directions. It can also handle pressure when you grip or pinch.

But there are two main challenges.

First, the materials cost 930 Euros. This is much more expensive than the Epping procedure. Second, in this group of patients, 4 spacers moved out of place. This is called dislocation. When this happens, the patient may need another surgery to fix it.

Here is where it gets interesting.

Even with these challenges, most patients still did well. The researchers say that more studies and longer follow up times will help doctors decide when this surgery is the best choice.

Frequently Asked Questions

Which surgery is better for thumb arthritis?

According to this study, both the Epping procedure and the pyrocarbon spacer surgery gave very good or good results for over 80% of patients. Patients were equally satisfied with both options. The best choice for you depends on your specific situation, cost, and what your surgeon recommends.

What are the risks of pyrocarbon spacer surgery?

Research shows that in this study, 4 out of 32 patients had the spacer move out of place after surgery. This is called dislocation. The surgery also costs more because the materials cost 930 Euros. However, the spacer allows good movement and can handle pressure well.

How many people have thumb arthritis?

Studies indicate that about 10 out of every 100 people have rhizarthritis. This makes it the most common type of arthritis in the hand. Many people can manage it with conservative treatments, but some need surgery when other treatments do not help enough.

Does surgery for thumb arthritis really work?

Medical evidence from this research suggests that yes, surgery can work very well. More than 80% of patients in both surgery groups got very good or good results. Patients were satisfied with their outcomes. Both the Epping procedure and pyrocarbon spacer surgery helped reduce pain and improve thumb function.

What Does This Mean for You?

If you have thumb arthritis that does not get better with other treatments, surgery can help. This study shows that two different surgeries both work well for most people. The Epping procedure has been used for a long time and gives good results. The pyrocarbon spacer is newer and also works well, but it costs more and sometimes the spacer can move out of place.

Talk with your doctor about which option is best for you. Ask about the benefits and risks of each surgery. Ask about cost. Ask how many times your surgeon has done each procedure.

Remember, more than 8 out of 10 patients felt much better after either surgery. That is a hopeful number. With the right treatment, you can reduce your pain and use your thumb more easily again.

About This Site

This website simplifies medical science for people with thumb pain and rhizarthrosis. We read published scientific articles and explain them in plain language. Every article we write is based on real research, not opinions. We invite you to explore more content on our site to learn about treatments, diagnosis, and living well with thumb arthritis.

Important Information

This article is for educational purposes only. It is not medical advice. It does not replace the advice of your doctor or healthcare provider. Always talk with a qualified medical professional before making decisions about your health or treatment. Every person is different, and what works for one person may not work for another.

Research Source

Study Citation:
Szalay, G., Schleicher, I., Alt, V., Pavlidis, T., & Schnettler, R. (2011). Operative treatment of rhizarthritis: comparison of ligament reconstruction according to Epping with trapezectomy and interposition of pyrocarbon spacers as replacement of the trapezium. Orthopade.

Read the full study here:
https://doi.org/10.1007/s00132-010-1729-7