If you have thumb pain from arthritis, you may have heard about surgery. Doctors have different ways to fix the joint at the base of your thumb. Some doctors take out a small bone. Others put in a new joint made of special materials. This article explains what researchers learned when they compared these two types of surgery.
Key Findings at a Glance
- Research shows that both surgeries helped with pain and daily activities equally well.
- According to this study, patients with the new joint (prosthesis) recovered faster. They were back to normal in about 4.5 weeks compared to 10 weeks for bone removal.
- The new joint kept the thumb height and shape better than removing the bone.
- Studies indicate that new joints can have problems like slipping out of place or bone breaking.
- Medical evidence suggests that traditional surgery had fewer complications overall.
Here are three things you will learn:
- What happens during each type of surgery
- How fast you can get better with each option
- What problems might happen with each choice
In This Article
What Is Rhizarthrosis and Why Does It Hurt?
When you have this condition, simple things become hard. Opening a jar hurts. Turning a key feels painful. Writing can make your thumb ache. You may be wondering why this matters. The joint at the base of your thumb is very important. You use it every day for almost everything you do with your hands.
Many people with thumb arthritis try medicine first. They might wear a special brace. Sometimes these things help. But when the pain does not go away, surgery can be an option.
What Are the Two Types of Surgery?
Doctors have two main ways to fix a worn out thumb joint. Let us look at each one.
Surgery One: Taking Out the Small Bone
The first type is called trapeziectomy. That is a big word. It means the doctor takes out a small bone at the base of your thumb. This bone is called the trapezium (a small bone in your wrist). It is one of the eight small bones in your wrist.
After the doctor removes this bone, there is a space. Sometimes the doctor adds extra support using your own tissue. This is called ligamentoplasty (a procedure using a tendon to help hold things in place). The doctor uses a piece of tendon (a tough cord that connects muscle to bone) to help hold things in place. Sometimes the doctor does not add this extra support. Either way, your body fills in the space over time with scar tissue.
Surgery Two: Putting In a New Joint
The second type is called arthroplasty with an implant. This means the doctor puts in a new joint. The new joint is called a prosthesis (a replacement joint). It is made of special materials that can move inside your body. Think of it like getting a new part for your thumb. The prosthesis replaces the worn out joint.
What Did the Researchers Do?
According to this study, doctors looked at 52 hands that had surgery between 1995 and 2008. Some patients had surgery on both hands, but each hand was counted separately.
Here is where it gets interesting. The researchers divided the hands into two groups.
| Group | Type of Surgery | Number of Hands | Follow Up Time |
|---|---|---|---|
| Group A | Bone removal with or without ligament support | 32 hands | 72 months (6 years) |
| Group B | New joint (prosthesis) | 20 hands | 23 months (about 2 years) |
The doctors checked how well each group did after surgery. They looked at pain levels. They checked if people could do their daily activities. They measured how much the thumb could move. They tested hand strength. They also took special pictures called X rays to see how the bones looked.
Did One Surgery Work Better for Pain and Strength?
Research shows that both types of surgery helped with pain. Both groups felt better. They could do their daily activities again. Their thumbs could move well. Their hand strength improved.
You may be wondering if one was clearly better. The researchers found that there were no big differences between the two groups for pain, activities, movement, or strength. Both surgeries worked about the same for these important things.
But the story does not end there. Let us look closer at what else the doctors found.
What About the Shape of the Thumb?
The doctors took X rays to see how the thumb looked after surgery. They measured something called scaphometacarpal height. This is the distance between two bones in your hand. It tells doctors if your thumb is staying in the right position.
According to medical evidence from this study, the new joint kept this height better. When doctors remove the bone, the thumb can get a little shorter over time. The prosthesis kept the thumb at a more normal height.
How Long Does Recovery Take?
This is where the two surgeries were very different. Studies indicate that recovery time matters a lot to patients. Getting back to your normal life quickly is important.
Research shows that patients with the new joint recovered much faster. The average time to get better was only 4.5 weeks. That is about one month.
Patients who had the bone removed took longer. The average recovery time was 10 weeks. That is more than two months.
This difference is big. If you need to get back to work or taking care of your family, a shorter recovery time can make a huge difference in your life.
What Problems Can Happen?
No surgery is perfect. Sometimes things can go wrong. The researchers looked at problems that happened after surgery. They are called complications.
According to this study, four patients had problems out of 52 hands. That is not very many. But it is important to know what can happen.
Problems with Bone Removal Surgery
In Group A, one patient had a problem called algoneurodystrophy. This is a condition where the hand becomes very painful and stiff. It can also swell up. Doctors are not sure exactly why this happens. It is also called complex regional pain syndrome.
Problems with the New Joint
In Group B, three patients had problems. Two patients had their new joint slip out of place. This is called dislocation. The prosthesis moved away from where it should be. One patient had a fracture. That means a bone broke near the implant.
About This Site
This site helps you understand medical science about thumb pain and rhizarthrosis. We read scientific articles published by doctors and researchers. Then we explain what they found using simple words. We only use real published studies. We never make up facts. You can explore more articles on this site to learn about other treatments, exercises, and ways to feel better.
Frequently Asked Questions
Which surgery is better for thumb arthritis?
According to this study, both surgeries helped with pain and function equally well. The new joint (prosthesis) allowed faster recovery in about 4.5 weeks compared to 10 weeks for bone removal. However, the prosthesis had more complications like dislocation and fracture.
How long will I need to recover after thumb arthritis surgery?
Research shows that recovery time depends on which surgery you have. If you get a prosthesis, the average recovery is 4.5 weeks. If you have the bone removed, the average recovery is 10 weeks. Your own recovery may be different.
What is trapeziectomy?
Trapeziectomy is surgery where the doctor removes a small bone called the trapezium from the base of your thumb. Sometimes the doctor adds extra support using your own tendon tissue. This is one common way to treat thumb arthritis.
Can the new thumb joint slip out of place?
Yes, according to this study, dislocation is a possible problem with prosthesis surgery. Two out of 20 hands in the study had the implant slip out of place. This is why doctors say prostheses should be used carefully.
What Does This Mean for You?
If you have thumb arthritis and are thinking about surgery, you now know more about two different options. Both types of surgery can help your pain. Both can help you use your hand again.
The new joint gets you back to normal life faster. It keeps your thumb shape better. But it can have more problems with the implant itself.
The traditional surgery of removing the bone takes longer to heal. But it had fewer complications in this study.
Your doctor can help you decide which surgery is right for you. Every person is different. Your age, how active you are, and what you need your hand to do all matter. Talk with your doctor about what you learned here. Ask questions. Make the choice that feels right for your life.
You are not alone in dealing with thumb pain. Many people have found relief through surgery. Take your time to learn and decide.
Disclaimer
This article is for educational purposes only. It is not medical advice. It does not replace talking to your doctor. Every person is different. Your doctor knows your specific situation. Always talk to your healthcare provider before making decisions about surgery or treatment. The information here comes from one scientific study and may not apply to everyone.
Scientific Source
Study by: Santos, C., Pereira, M. A., Silva, L. F., Claro, R. M., Trigueiros, M. N., & da Silva, J. C. (2011). Surgical Treatment of Rhizarthrosis: Trapeziectomy with or without Ligamentoplasty Versus Total Prosthesis. Rev Bras Ortop.
Read the full article:
https://doi.org/10.1016/S2255-4971(15)30181-6