Wondering which treatment is right for you? This side-by-side comparison covers every major option for rhizarthrosis, from splinting to joint replacement. Based on published clinical evidence.
Conservative vs. Surgical: Quick Overview
Conservative Treatment
- Best for Eaton Stage I-II
- No surgery, no anaesthesia
- Can delay or prevent surgery
- Can be combined with injections
- May need ongoing management
Surgical Treatment
- Best for Eaton Stage III-IV
- Definitive solution for severe pain
- Multiple procedure options
- Recovery: 6 weeks to 6 months
- High satisfaction rates (85-95%)
Full Treatment Comparison Table
| Treatment | Type | Best Stage | Pain Relief | Recovery | Duration |
|---|---|---|---|---|---|
| Thumb Splint | Conservative | I-III | 30-50% reduction | Immediate | Ongoing |
| Hand Therapy | Conservative | I-III | Moderate | Immediate | 8-12 weeks programme |
| Cortisone Injection | Conservative | I-III | Significant (70%) | 1-2 days | 3-6 months |
| Hyaluronic Acid | Conservative | I-III | Moderate | 1-2 days | 6-12 months |
| PRP Injection | Conservative | I-III | Moderate-Good | 2-3 days | 6-12 months |
| Fat Injection | Conservative | II-III | Emerging data | 1-2 weeks | Under study |
| Surgical Options | |||||
| Trapeziectomy | Surgical | III-IV | 85-90% satisfied | 6-12 weeks | Permanent |
| Trapeziectomy + LRTI | Surgical | III-IV | 85-95% satisfied | 8-12 weeks | Permanent |
| Joint Replacement | Surgical | III-IV | 90-95% satisfied | 4-8 weeks | 10-15+ years |
| Arthrodesis (Fusion) | Surgical | III-IV | High (eliminates pain) | 8-12 weeks | Permanent |
| Arthroscopy | Surgical | I-II | Variable | 2-4 weeks | Varies |
| Osteotomy | Surgical | I-II | Good for select patients | 6-8 weeks | Long-term |
Decision Flowchart
1. Diagnosed with rhizarthrosis → Start with conservative treatment (splint + therapy)
2. 3-6 months, not enough relief? → Try injection therapy (cortisone or HA)
3. Still symptomatic + Stage III/IV? → Discuss surgery with your hand surgeon
4. Younger, active patient? → Consider joint replacement (faster recovery)
5. Older or low-demand patient? → Consider trapeziectomy (proven track record)
6. Pantrapezial arthritis (Stage IV)? → Trapeziectomy (implant may not be suitable)
Remember: This flowchart is a simplification. Your surgeon will consider your specific anatomy, bone quality, activity level, and preferences. Return to our Start Here guide for a full roadmap.
Medical Disclaimer: This comparison is based on published clinical evidence and is intended for educational purposes only. Individual results vary. Always consult your healthcare provider.