Thumb Joint Replacement
One of the most common sites for arthritis is the base of the thumb (the CMC joint). Arthritis at this joint may result in persistent aching pain at the base of the thumb aggravated by attempts to use the thumb for activities such as key-pinch, opening jars, turning door knobs, writing, etc. Initially, arthritis at this joint may be managed conservatively with rest, activity modification, NSAIDs such as ibuprofen or naproxen, splints, steroid injections, and/or injections of blood products or bone marrow aspirate (“stem cells”). However, as the arthritis progresses, eventually these more conservative approaches become less and less effective. When this point is reached, thumb joint replacement is the best option for relieving pain and maintaining function. Dr. Fremling has been performing thumb joint replacement for over 20 years. He utilized his personal modification of the suspension arthroplasty/tendon interposition technique originally described by Burton. In this thumb joint replacement operation, the trapezium (a small bone at the base of the thumb) is removed through a transverse incision to minimize scarring and a tendon from the wrist is used to suspend the thumb metacarpal and to act as a replacement for the trapezium. While this thumb joint replacement operation typically results in good pain relief while maintaining good motion, recovery involves no use of the thumb at all for 8 weeks and up to a year or more for maximum recovery of function. The good news is that unlike artificial joint replacements, this tendon thumb joint replacement rarely wears out and often patients experience satisfactory pain relieve for the rest of their lives.