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Conditions & Treatments

Joint Replacement Surgery

Carpal Meta-Carpal (CMC) Arthroplasty

Opposable thumbs are one characteristic that separates us from most animals. Opposable thumbs make it possible for humans to pinch and grasp.  Opposable thumbs allow us to hold a pencil and write, put on socks and shoes, open a doorknob, button a button, pull up a zipper, brush our teeth, and open a jar. When the thumb joint becomes arthritic with age, it substantially impairs independence and quality of life.

What is CMC joint?

The CMC joint is the joint at the base of the thumb that joins the thumb to the wrist. It involves the carpal and meta-carpal bones and also the trapezium bone in the wrist at the base of the thumb. The thumb joint is unique because it allows the thumb to move in many directions tolerates a significant amount of wear and tear.   The wide range of motion comes at a cost, an increased risk of arthritis which alters the shape and function of the joint and weakens the supporting ligaments. Arthritis affects the carpal metacarpal joint where it meets the wrist bone, the trapezium.

What is thumb arthritis?

Osteoarthritis (OA) of the thumb is common. It occurs when the articular cartilage that lines the ends of the bones slowly wears away over time causing the bones rub causing inflammation and resulting in significant pain, movement restriction and bone spurs. Osteoarthritis of the thumb affects the strength of the fingers and the hand and impairs the ability to grasp. Women over age 50 are 10 to 20 times more likely than men to develop thumb arthritis. OA affects mobility and function.

What are the symptoms?

  • joint pain and stiffness
  • tenderness and swelling
  • difficulty grasping and pinching
  • pain with activities that require grasping
  • an aching joint after continued use
  • loss of grip strength
  • restricted motion
  • an abnormally enlarged joint
  • carpal tunnel syndrome symptoms

How is it diagnosed?

Your OANC hand and wrist surgeon will review your health history, ask about previous injury to the joint, what causes or aggravates your pain, and test your ability to grasp.  X-rays will be ordered to view the joint and evaluate joint deterioration, bone spurs and calcium deposits in the joint.

What are the treatment options?

The goal of all treatment options is to relieve pain and improve function. Many cases can be managed with conservative treatment.

Conservative Treatment

Conservative Treatment involves the use of anti-inflammatory medications, splints to immobilize the joint, activity modification, hand therapy and sometimes steroid injections will help to make you feel better. Many people respond positively to conservative management; however, it doesn’t stop or delay progression. When the damage is severe and pain and dysfunction destroy your quality of life, a thumb joint replacement may be recommended.

CMC Joint arthroplasty

CMC Joint arthroplasty is joint replacement/reconstruction surgery. There are several types of thumb joint surgery. All of the damaged boney parts of the thumb joint are removed and replaced them with implants made of metal or synthetic materials. Then the soft tissue (tendon) is reconstructed and provides cushioning for the joint to improve stability.

Most patients go home the same day. The thumb and wrist will be immobilized with a splint or cast for 4-6 weeks. Then physical therapy is important to restore range of motion and strength.

Risks are rare and the surgery provides significant pain relief and improved mobility in 95% of patients.

Schedule a consultation

Orthopedic Associates of Northern California is a dedicated team of caring, compassionate experts whose goal is to restore your quality of life and function. Our board – certified orthopedic surgeons work in a state-of-the- art facility that is conveniently located in Chico California with physical therapy on site. When are suffering with pain and stiffness in your thumb joint, contact us to schedule a consultation and receive the correct diagnosis and all your treatment options.

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