Which Thumb Surgery Works Better for Advanced Arthritis?

If you have severe thumb pain at the base of your thumb, you may have heard about different types of surgery to help. This can feel overwhelming. You are not alone. Many people want to know which surgical option gives the best results.

This article looks at a study that compared two popular thumb surgeries for rhizarthrosis. That is the medical name for arthritis at the base of your thumb. The study followed 85 people for 12 months after surgery. It found clear differences in how well the two surgeries worked.

Here are three key points:

• One surgery kept the thumb more stable and reduced pain more.
• People who got that surgery also regained more grip strength.
• Both surgeries helped, but one was clearly better in all the measurements.

What is rhizarthrosis and who gets it?

Rhizarthrosis is arthritis that happens at the base of your thumb. This joint is called the first carpometacarpal joint. That is where your thumb bone meets a small bone in your wrist called the trapezium bone.

According to this study, rhizarthrosis is most commonly observed in people whose work and activities involve heavy use of the wrist. If you use your hands a lot every day, you may be at higher risk. This includes people who type, use tools, or do repetitive gripping.

In the early stages, doctors can help with medicines and splints. But in advanced stages, surgery becomes the main treatment approach. That is when the joint is too damaged for other treatments to work well.

What are the two surgeries the study compared?

Let us look closer. The study compared two types of surgery. Both remove the damaged trapezium bone. That is the small wrist bone that rubs against the thumb bone and causes pain. But they handle the space left behind in different ways.

Resection interposition arthroplasty

The first surgery is called resection interposition arthroplasty. The doctor removes the trapezium bone. Then the doctor places a piece of soft tissue in that space. This tissue acts like a cushion. It keeps the bones from rubbing together.

Resection suspension-interposition arthroplasty

The second surgery is called resection suspension-interposition arthroplasty. The doctor also removes the trapezium bone. Then the doctor adds a cushion of soft tissue. But there is one more step. The doctor also suspends the thumb bone in place using a tendon. That means the doctor uses a strong cord of tissue from your body to hold the thumb bone stable.

Here is where it gets interesting. The suspension step may keep the thumb from sinking down over time. That could mean less pain and better strength.

How did the study work?

Research shows that this study followed 85 patients with stages II to IV rhizarthrosis. That means the arthritis was moderate to severe. All patients had surgery between 2017 and 2022.

The patients were divided into two groups. The first group had 52 people. They received the suspension-interposition surgery using an original technique developed by the doctors. The second group had 33 people. They received the interposition surgery without the suspension step.

The doctors measured four things at 12 months after surgery:

• Pain levels using a scale called the Visual Analog Scale for Pain, or VAS.
• How well the arm and hand worked using a scale called the Disabilities of the Arm, Shoulder, and Hand scale, or DASH.
• The distance between the thumb bone and the trapezium space on X-rays. A bigger distance means the thumb stayed more stable.
• Grip strength in the hand that had surgery.

You may be wondering why these measurements matter. They show whether the surgery truly helps with daily life. Pain, function, stability, and strength are what you care about most if you have this condition.

What did the results show?

According to this study, the suspension-interposition surgery gave better results in every measurement. Let us break down what the numbers mean.

Pain relief

Studies indicate that the suspension-interposition surgery improved pain by 76% more than the other surgery. This was measured using the VAS scale. Lower pain means you can use your hand more comfortably.

Hand function

Research shows that patients who had the suspension-interposition surgery improved their DASH score by 73% more. The DASH scale measures how well you can do daily tasks like opening jars, turning keys, and writing. A better score means you can do more with less trouble.

Grip strength

According to medical evidence, people who got the suspension-interposition surgery gained 60% more grip strength. Grip strength is how hard you can squeeze with your hand. This matters when you carry grocery bags, open doors, or hold tools.

Thumb stability

The suspension-interposition surgery kept the thumb bone 30% more stable. The doctors measured this by looking at X-rays. They checked the distance between the base of the thumb bone and where the trapezium bone used to be. A bigger distance means the thumb did not sink down. That helps it stay strong and pain free.

Why does this matter for you?

If you are considering surgery for thumb arthritis, this study gives you valuable information. It shows that adding the suspension step makes a real difference. The benefits were clear in pain, function, strength, and stability.

Both surgeries helped people feel better. But the suspension-interposition surgery worked better in every way the doctors measured. This could mean fewer problems later and a better quality of life.

Of course, every person is different. Your doctor will help you choose the best option for your specific situation. But knowing what the research shows can help you ask better questions and feel more confident.

Frequently asked questions

What stage of rhizarthrosis needs surgery?

According to this study, surgery is used for stages II to IV rhizarthrosis. These are the moderate to severe stages. In early stages, doctors often try medicines, splints, and other treatments first. Surgery becomes the main option when the joint is too damaged for those treatments to help.

How long does it take to recover from thumb arthritis surgery?

This study measured results at 12 months after surgery. That means it took a full year to see the final benefits. Recovery time can vary from person to person. Your doctor will guide you through the healing process step by step.

Will I be able to use my hand normally after surgery?

Research shows that patients who had the suspension-interposition surgery improved their hand function by 73% compared to the other surgery. Many people regain the ability to do daily tasks with less pain and better strength. Your results will depend on your specific condition and how well you follow rehabilitation instructions.

Is one surgery safer than the other?

The study did not report major safety differences between the two surgeries. Both are established procedures. The main difference is in how well they work. The suspension-interposition surgery gave better results in pain relief, function, grip strength, and thumb stability.

Conclusion

Thumb arthritis at the base of your thumb can make daily life very difficult. Surgery can help when other treatments no longer work. This study shows that resection suspension-interposition arthroplasty gives better results than resection interposition arthroplasty alone.

The suspension technique reduced pain more, improved hand function more, increased grip strength more, and kept the thumb more stable. These are the things that matter most in your everyday life.

If you are thinking about surgery, talk with your doctor about these findings. Ask which type of surgery might be best for you. Bring your questions. You deserve to understand all your options.

You are not alone on this journey. Many people have found relief and regained strength through surgery. With the right information and the right care, you can look forward to using your hand more comfortably again.

Disclaimer

This article is for educational purposes only. It is not medical advice. Always talk with your doctor before making any decisions about your treatment. Your doctor knows your personal health history and can guide you to the best choice for your situation.

Article citation

Egiazaryan, Karen A.; Parsadanyan, Gaik K.; Ershov, Dmitry S.; Skvortsova, Mariya A.; Ratiev, Andrey P.; Afanasiev, Aleksei V. (2023). Mid-Term Results of Surgical Treatment for Rhizarthrosis Using Interposition and Suspension-Interposition Arthroplasty. Traumatology and Orthopedics of Russia.

https://doi.org/10.17816/2311-2905-17288