Easier Thumb Surgery

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By Kathy Allen

Osteoarthritis is a degenerative joint disease that causes cartilage to gradually wear away. Thumb osteoarthritis commonly affects the joint at the base of the thumb, which is known as the basal joint. To diagnose thumb osteoarthritis, doctors typically conduct a physical exam, which can reveal an abnormal range of motion, swelling and pain or tenderness at the base of the thumb. X-rays can reveal joint damage.

SYMPTOMS: Pain is the most common symptom associated with thumb osteoarthritis. Other symptoms may include:
•Difficulty gripping objects
•Swelling, stiffness or tenderness at the base of the thumb
•Enlarged appearance of the basal joint
•Limited range of motion

STANDARD TREATMENTS: Treatments for early osteoarthritis of the thumb may include nonsurgical options such as nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and swelling, icing the joint, physical or occupational therapy, splinting to restrict movement of the thumb, and steroid injections into the joint.

STANDARD SURGICAL OPTIONS: Surgical options for people with osteoarthritis of the thumb may include:
•Joint fusion – This is an option for patients looking for pain relief who are not overly concerned about losing fine thumb motion.
•Trapeziectomy – This is the removal of a small bone called the trapezium.

NEW, EASIER SOLUTION: There's now an easier option for some patients with thumb osteoarthritis. Surgeons insert a small spacer between the bones made from a polymer called Artelon. The spacer separates and stabilizes the joint and is tissue-preserving. It avoids removing the trapezium bone, which keeps the anatomy of the hand intact. Over time, the Artelon dissolves and leaves behind the patient's own tissue to cushion the joint. The ideal patient for this procedure is someone who is in the early stages of osteoarthritis but has not responded to conservative treatments. Three-year results from an ongoing pilot study on patients treated with the spacer show an improved thumb function, stable joints, much improved grip strength and pain relief.

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