Base of Thumb Arthritis

What is Base of Thumb Arthritis?

Arthritis is the gradual wear and tear of cartilage, which results in the loss of a smooth gliding motion for the joint and causes the associated pain and restricted movement. It is most common in the hand.

Commonly misunderstood as the bone-on-bone traction, Arthritis is actually the degradation of the cartilage which happens over time in stages:

Stage 1 – Cartilage softens

Stage 2 – Surface cracks develop

Stage 3 – Deterioration and flaking, known as ‘fibrillation’

Stage 4 – Cartilage wears away to expose the bone surface

Basal Joint Arthritis usually affects people from the age of 40, more commonly from 60 years, and is more prevalent in women.

Commonly, there is no specific cause identified for Basal Joint Arthritis, and therefore given the term Idiopathic or Primary Osteoarthritis. It could be related to trauma like fractures or injury, rheumatoid disease or other connective tissue disorders.

Common causes of Basal Joint Arthritis are:

Osteoarthritis – this is the most common cause of Arthritis. A degenerative joint disease which affects all cartilage and joints in the body, it usually affects people over the age of 50.

Rheumatoid Arthritis – an autoimmune disorder in which the immune system attacks healthy cells such as the lining of joints. It is an inflammatory condition and often manifests symmetrically, affecting both hands at once. Rheumatoid Arthritis is more common in women, and often affects the small joints of the body first, such as hands and fingers, before involving the larger lower limb joints.

Post-Traumatic Basal Joint Arthritis – can develop after an injury to the hand and thumb, such as a fracture, dislocation or other damage.

Signs of Arthritis in the base of the thumb may include:

  • Pain in the joint at any time whether still or moving
  • Stiffness and reduced range of motion
  • Hand weakness
  • Loss of dexterity and fine motor skill
  • Swelling and deformity around the joint

Hand Anatomy

At the base of the thumb, there is a joint to connect it to the wrist – the basal joint. This is the hand’s most mobile joint, allowing swivel, pivot, pinching and gripping action.

This as well as every other joint in the body, has cartilage, a 2 to 3-millimeter thick layer of tissue designed to make contact between bones softer and the movement of the joint smooth.

Treatment & Surgery Options

Early management for Basal Joint Arthritis is usually nonoperative and could include:

  • Exercises and stretches to increase range of motion
  • Lifestyle and activity modifications to avoid worsening
  • Pain management with ice, heat or medication
  • Weight optimization
  • Cortisone or Hyaluronic Acid injection
  • Medication for Rheumatoid Arthritis
  • Dietary supplements

When nonoperative treatments are not offering enough relief, surgical options may be considered.

There are a range of procedures, which are considered on an individual basis. These include:

  • Removal of loose fragments of bone, cartilage or inflamed tissue in the joint
  • Removal of half of one the bones of the joint to decompress the joint and allow more space
  • Ligament or tendon reconstruction or replacement
  • Fusing the bones of the joint together (this solution limits movement)
  • Osteotomy to reshape the bone
  • Joint resurfacing
  • Suspensionplasty for severe cases will remove a small wrist bone and stabilize the thumb with an implant

Downloadable info sheets related to Base of Thumb Arthritis

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