James C. Cassandra, DO
Orthopedic Hand & Elbow Surgeon
At OrthoNeuro in Columbus, Ohio, our orthopedic hand surgeons are experts that understand how vital it is for you to have healthy hands.
Your hands must function correctly and without pain, so you can achieve your most basic needs and perform complex and delicate movements.
However, severe arthritis in the joints of your hand can often rob you of that basic function.
That’s where hand arthroplasty could be beneficial for patients.
Arthroplasty is the procedure of removing a damaged joint and replacing it with either an artificial implant or interposing a tendon or other tissue.
A joint may be damaged because of osteoarthritis. The articular cartilage that normally cushions the ends of the bones wears away over time, causing pain and limiting movement.
Rheumatoid arthritis or another type of inflammatory arthritis can also damage the joints.
The goal of this surgical procedure is to relieve pain and restore the function of the hand.
One of the most common hand joint replacement surgeries is used for patients with thumb arthritis, otherwise known as basal joint arthritis.
You may also hear the basal joint be referred to as the carpometacarpal (CMC) joint.
The joint forms at the wrist where the ends of the metacarpal bone at the base of the thumb and the trapezium bone meet.
Those with a painful thumb carpometacarpal joint may benefit from thumb arthroplasty.
There are several surgical procedures available to treat arthritis affecting the base of the thumb joint.
The most common procedures for thumb arthritis involve stabilizing the thumb metacarpal bone and using tissue from your tendon as a joint spacer (ligament reconstruction).
This is known as an interposition arthroplasty and is the most common type of arthroplasty performed on the hand.
Other types of arthroplasties from a historical standpoint for the thumb that are not commonly performed are as follows:
Prosthetic implant – The surgeon makes an incision where the thumb meets the wrist bone and opens the joint. The surgeon then clears away the damaged cartilage from either end of the bones in order to prepare for the implant.
If the implant has a stem attachment, the surgeon will create a small hole for the implant to attach to. Finally, the new joint is reinforced using nearby tendons.
Spherical implant surgery – The surgeon inserts a small ceramic ball between the ends of the bones to form a new joint. The ends of the bones are removed to create an area for the ball to fit snugly in the joint.
These procedures have been shown to be as successful as the current standard of care, that of an interposition arthroplasty for the thumb.
Other joints in the hand and fingers do use the above implants for joint replacement.
Once surgery has finished, the thumb will be protected and placed into a splint. Pain medication will be required to control discomfort.
Keeping your hand elevated as much as possible will also help reduce swelling as well as pain.
As you begin to heal, physical therapy or occupational therapy will help you to regain motion, strength, and coordination at the CMC joint.
The procedure usually requires either general or local anesthesia. These medications will block any pain during the surgical procedure.
You may feel some discomfort following the surgery. However, you can relieve pain using over-the-counter pain relief.
Recovery requires a period of immobilization followed by therapy. The thumb will be immobilized for approximately 3 months, this can vary per physician.
Most patients continue to make progress with their recovery for many months after surgery, even up to a year.
If you are experiencing severe arthritis in your hand, schedule an appointment with one of our Board Certified Orthopedic and Sports Medicine Specialists at one of our 7 convenient locations throughout Greater Columbus.
Best of all, most patients can be seen within 24 hours of making an appointment.
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