Basal joint reconstruction treatment and surgery

Basal joint reconstruction treatment and surgery

The basal joint allows you to move your thumb into the palm of your hand, a motion called opposition. Repetitive motions can weaken the basal joint, wear down the articular cartilage surrounding the joint and make it more susceptible to degenerative arthritis. Basal joint reconstruction surgery is a procedure for people with advanced "wear and tear" arthritis in the basal joint of their thumb that has not improved with nonsurgical approaches. In these more severe cases, surgery is the most successful treatment. Also known as arthroplasty, reconstruction surgery on the basal joint relieves pain and restores functionality to the thumb.

In a healthy thumb, cartilage forms a slick and spongy protective covering for the ends of the bones and allows them to glide smoothly on each other at the joint. When the cartilage is damaged, the raw bones start to rub against each other and arthritis sets in. Basal joint arthritis symptoms, such as debilitating hand pain, swelling, decreased strength and hindered range of motion, can make even the simplest daily activities difficult to do. Most arthritic conditions tend to be progressive.

During basal joint reconstruction surgery, your orthopaedic hand surgeon removes the degenerated trapezium bone or a portion of the trapezium bone, one of the bones that form the thumb's basal joint, also known as the carpometacarpal (CMC) joint. The basal joint is made up of the trapezium bone and the first metacarpal bone. This joint is located at the base of the thumb, in the palm where the thumb meets the wrist. There are several acceptable variations of the surgery used to treat basal joint arthritis. In the most commonly performed operation, the surgeon replaces the trapezium with a piece of tendon that fills the space left by removing the bone and serves as a cushion for the first metacarpal bone. The surgeon also uses more of the tendon to secure the first metacarpal in place. A very common procedure with long-lasting results, basal joint surgery removes the arthritis and is very effective in eliminating the pain.

Results

After basal joint reconstruction surgery, your thumb and hand are placed in a splint to provide support, to control postop pain, and to promote healing. Rehabilitation consists of hand exercises and physical therapy or occupational therapy to help you strengthen your thumb and regain motion and coordination. Recovery takes an average of three to six months. After the reconstruction patients are again able to do many of the activities that they were unable to do because of the arthritis.

The multidisciplinary team of hand and wrist experts at Northwell Health Orthopaedic Institute treats basal joint arthritis as well as a broad range of conditions affecting the hand and wrist areas.

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