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Home / Common Conditions / Basal Joint Arthritis

Basal Joint Arthritis

Thumb arthritis is the most common form of osteoarthritis affecting the hand

thumb arthritis surgery miamiAlso called basal joint arthritis, thumb arthritis occurs when the cushioning cartilage wears away from the adjoining ends of the bones that form your thumb joint (carpometacarpal joint). Thumb arthritis can cause severe hand pain, swelling, and decreased strength and range of motion, making it difficult to do simple household tasks, such as turning doorknobs and opening jars. Treatment for thumb arthritis may include self-care measures, splints, medication or corticosteroid injections. If you have severe thumb arthritis, you may need surgery.

Surgical Options for Thumb Basal Joint Arthritis

Early Surgical Treatments

One of the earliest surgical treatments described was complete excision of the trapezium. This was a simple operation, first described by Gervis in 1949. It is ironic that we have come full circle regarding surgical treatment, since Meals recently described a similar procedure in the literature nearly 50 years later.

A more complex modification of this procedure has been described as the LRTI (ligament reconstruction tendon interposition). This has been, and remains, the most commonly used surgical procedure for treatment of painful basal joint osteoarthritis. This relatively complex operation combines several previously described procedures, encompassing the complete excision of the trapezium bone and stabilization of the metacarpal base, using a strip of the flexor carpi radialis wrist tendon in order to stabilize the newly formed joint.

While reports in the literature are generally favorable in terms of the outcome, there are several problems that remain with this operation. One of them is that the recovery process is relatively long and can be painful. More details about this early surgical option can be found here.

Patient Testimonial: Thumb Joint Replacement. No pain.

Total Joint Arthroplasty

Total joint replacement remains a viable alternative in older patients where functional recovery is rapid, and there is a good salvage potential if necessary. While long-term studies are scarce, it is implicit that loosening of the implants can occur in scenarios where a great deal of stress is placed on the joint. For this reason, alternatives have been sought and a new concept has recently been developed.

The Role of Arthroscopy

The concept of arthroscopy may be most beneficial in the early stages of basal joint arthritis. The earliest presentation of this painful condition has few surgical options once conservative treatment has been exhausted. It is obvious that a 35-year-old active woman may not agree to a complete open excision of the trapezium, even when her symptoms are persistent.

The other surgical options discussed are also relatively aggressive for the younger, active patient. Hence, failed conservative treatment of basal joint osteoarthritis in the younger, active patients remains a dilemma. However, there is now a viable alternative in arthroscopy.

The patient who continues to have pain, despite several cortisone injections and prolonged splinting, may agree to an arthroscopic procedure. This is because a minimally invasive procedure at this small joint presents the same advantages that it does in larger, but more accepted, procedures, such as knee arthroscopy.

An arthroscopic evaluation of this joint gives us the true stage of arthritis and minimizes the importance of radiographic staging. In fact, an arthroscopic classification has been suggested, and may well lead to the treatment options.

More advanced arthroscopic stages dictate more aggressive treatment. Learn more about arthroscopic stages.

Read also: Treatment of Early Basal Joint Arthritis Using a Combined Arthroscopic Debridement and Metacarpal Osteotomy

Future options for the painful osteoarthritic basal joint of the hand

As the population ages and continues to be more active, it will be necessary to provide different options for the painful osteoarthritic basal joint of the hand. Newer technologies, such as small joint arthroscopy, or advances in biomaterials will lead to greater treatment options at this small but critical joint. Resection arthroplasty, or fusion, will likely continue to have a role in treatment, but I suspect that over time it will not be the primary option as is currently the gold standard.

For more information regarding thumb arthritis surgeries, please call Badia Hand to Shoulder Center at (305)227-4263, or request an appointment through the form below.

Related Posts:

  • Arthroscopic Options for Treating a Painful, Arthritic ThumbArthroscopic Options for Treating a Painful, Arthritic Thumb
  • Thumb Joint Replacement for Basal Joint ArthritisThumb Joint Replacement for Basal Joint Arthritis
  • Treating Patients With Thumb ArthritisTreating Patients With Thumb Arthritis
  • Thumbs Up on This ImplantThumbs Up on This Implant
 

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Not good for pediatric patients . Long wait time, so had a lot of ppl waiting. Would not let me wait on chaira... outside of xray room but rather in the outside waiting room even though my child was only 10. Don’t take pediatric patients if you can’t properly accommodate one guardian.read more
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I am really satisfy with my hand surgery that was done by Dr. Alejandro Badia, and I want to thanks all the... professional personal and staff that always are very kind. I highly recommended!read more
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Dr. Badia is an outstanding Dr and surgeon. I first sought his expertise, in late 2013, after a misdiagnosis and a... botched surgery by another Dr that left me with unbearable pain and unable to move my right hand for months. After doing some research online, looking for some excellent hand surgeons, a lot of articles came up praising Dr. Badia's expertise and competence. I sent him an email explaining what happened, how the pain started and asked for his opinion. To my surprise, I received a thorough response the same day with detailed information. I right then decided to drive 4hours to go see him; I must say it was the best decision I made. From the 1st visit, Dr. Badia performed surgery to fix the initial issue and later did another surgery to correct the botched one; I couldn't be happier with the results. Earlier this year, I slipped and injured my left wrist. I made another trip to Miami and once again Dr. Badia came to the rescue. He did surgery on my left wrist after the conservative treatment didn't fully help and at the same time did a cubital nerve release on my right elbow that instantly stopped the pain I've been having. I HIGHLY recommend Dr. Badia; he's a true expert and an outstanding surgeon. His staff is very kind, professional, friendly and truly cares.read more
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My husband and I contacted Dr Badia for my hand issues. I had researched approximately five hand specialists in... Florida and one in New York city before I found Dr Badia about an hour away from us. My husband and I went to Doral, Florida and the minute I met Dr Badia I knew he was going to do my surgery. He has personality plus !!! and loves what he does. He is kind, patient and listens to his patients. He respects your hands ! Dr Badia was highly recommended and I am so glad that we found him. He did the surgery on my hand and with a bit of rehab it healed better than I expected and my pain was gone ! Dr Badias office personnel are wonderful ! It is quite obvious that they love working there with him and that they love their jobs. My husband and I have never experienced an office with so many helpful and caring people. We both recommend Dr Badia. We still drive to his office for anything to do with hand issues and he takes care of whatever it is. We both trust our hands ONLY to him ! He is a gem.read more
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I first contacted Dr. Badia's clinic after I injured my hamate bone. I needed a surgery and someone in my family that... knew Dr. Badia convinced me that he was one of the best if not the best hand surgeon in the world. I am a high level Baseball player so I needed treatments in order to get back on the field as soon as possible. I have been able to book an appointment the next week which was great. I'm Canadian which made it tougher with my insurance company, but Dr. Badia's team has been really helpful with that, they sent numerous emails and even made some calls with the company to make sure I would not have any fees related to the consultation and surgery. The surgery went really well, without any complication and I don't think it would have been as quick and easy with anyone else than Dr. Badia and his team. I would definitively recomand Badia Hand to Shoulder Center to anyone in the need of treatments.read more
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I injured my shoulder right as we entered into a lockdown due to a pandemic. It was next to impossible to get anyone to... see me and assess my injury. Dr. Badia and his team, following carefully laid out safety protocols, were able to bring me in, have x-rays, MRI and thorough review of the findings all in ONE visit!!! I was given an interim treatment plan to bridge the gap as surgeries were restricted due to COVID-19. As soon as surgeries resumed, I was scheduled for my procedure. To say that both Dr. Badia and his team are amazing is an understatement. They helped me handle a difficult insurance approval process to ensure I had the best surgeon treating me and my procedure at The Surgery Center at Doral and communication with my PCP and Cardiologist was excellent. Everyone made me feel very safe and confident that I was in the best possible setting where I wouldn’t be exposed to needless risk in a traditional hospital. The results of my surgery so far have been amazing. I’ve had next to no pain post-op and my recovery is coming along at lightning speed thanks Dr. B’s amazing talent and the dream team he has at OrthoNow where I have been undergoing physical therapy. I couldn’t say enough good things about him and the team. His expertise and dedication to providing the best possible care using cutting edge technology make for patient centered care and well being vs. insurance driven red tape so often seen today. Highly recommend Dr. Badia!read more
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I went to Dr. Badia with a bad infection in my nail. He is so good at what he does and took care of me with such... concern. Gigi is the sweetest, cutest thing ever, who also made sure that I was comfortable and helped so I would not be nervous. The whole staff makes you feel like family. Thank you everyone from the bottom of my heart and I would recommend Dr. Badia's expertise and his office to anyone. So, if you have an injury or a problem, please go see him.read more
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Dr Badia is the best orthopedic surgeon in Miami hands down. I need surgery because of a multiple fracture in my left... forearm. Went to other doctors (UM, mount Sinai) and they didn’t promise me I would recover 100% of my injuries and told me I would not be able to do sports again. Dr Badia did tell me I would heal 100% and it’s true. I did a much simpler surgery and fixed me in no time. Would recommend to anyone. Two thumbs upread more
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The Dr and staff are professional and friendly. I’m happy I came here and I received the attention and answers I... needed. I had injured my hand and I left the office feeling better. Thank you all for everything!!!read more
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Staff displayed professionalism and caring. Dr. Badia was as enthusiastic as I was about this surgery to improve the... function of my hand. The surgical day process was smooth; I was kept informed every step of the way. I felt comfortable and safe.read more
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From the first call I made to Dr. Badia‘s office I was impressed by the professionalism of the person who answered... the phone. When I arrived at the office for my appointment I was once again greeted in a professional manner. This professionalism radiated through all of the team. I hadn’t seen Dr. Badia for over 10 years and he greeted me as if we’ve been in contact with each other for years.read more
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From my first visit the staff as well as the Dr. Badia have been exceptionally professional and caring. I had an injury... to my pinky finger, the required a placement of a rod in order to align. The surgery went well and was scheduled right away. The office staff has been amazing with scheduling and confirming appointments. Overall I am very happy with the care i received as well as the results. My finger healed and my range of motion has also gotten much better. Thank you Dr. Badiaread more
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