Thumb Basal Joint Arthritis Thumb basal arthritis, or carpometacarpal (CMC) arthritis, is usually related to wear and tear in the basal joint of the thumb. The name is the trapeziometacarpal joint, and often is referred to as the TMC or CMC joint. The symptoms involve pain at the base of the thumb, especially with pinch and gripping. It is very common in women, especially over 50 years of age and mostly is due to osteoarthritis. In women over 70 years old, a majority have Xray findings of arthritis in this joint, but frequently is not bothersome.
Xray of arthritic thumb and picture of custom thumb splint
Treatment involves over the counter pain medicine such as ibuprofen or naprosyn. Cortisone injections can be given, and short course of hand therapy for a custom thumb splint and strengthening program can often be helpful. For patients that do not respond to conservative measures and have continued pain, a thumb basal joint reconstruction is a good option. This procedure has many names, such as LRTI (ligament reconstruction tendon interposition), TMC or CMC reconstruction, carpometacarpal arthroplasty, anchovy procedure, and basal joint arthroplasty among others. The names are varied, but most are a time-tested variation on the same procedure: a trapezium bone excision and tendon transfer. I perform a minimally invasive version of this procedure that I feel reduces pain and recovery time. I use a 1 inch incision (verses several incisions), and perform the trapezium excision and tendon transfer through this. I usually place a cast on the thumb for the 1st month, a removeable splint the 2nd month, and a strengthening program for the 3rd month after surgery. Due to the smaller surgical exposure I feel there is a faster recovery and return to activities.
Incision for minimally invasive reconstrucion
For appointments call 925-939-8585 Monday through Friday 8am to 5pm
