CMC-1 osteoarthritis

Osteoarthritis of the thumb base joint (CMC-1 joint) Osteoarthritis is a condition of the articular cartilage, also known as joint wear. Osteoarthritis is a condition in which joint cartilage deteriorates in quality and may even disappear completely in the long run. The bone ends then come together, causing pain. It also makes it more difficult to move the affected joint. Furthermore, in response to the reduced cartilage protection, the bone will start to enlarge its supporting surface to reduce the pressure on the joint. As a result, the joint may form protrusions (osteophytes), thicken and become deformed. The process of deterioration of cartilage does not stop and slowly increases. Osteoarthritis cannot be cured. However, the process can be slowed down. It has nothing to do with osteoporosis (decalcification of bones). The pain in osteoarthritis is largely caused by inflammation (sterility) of the capsule surrounding the joint 4 In the hand, osteoarthritis often occurs in the base joint of the thumb. This joint is formed by the first metacarpal bone (os metacarpale 1) and a carpal bone (os trapezium), this together is called the thumb base or CMC-1 joint.

Complaints associated with osteoarthritis of the base joint of the thumb:

  • Pressure pain in the area of the thumb base joint, which increases when force is applied.
  • Unable to move the thumb away from the palm properly.
  • Loss of strength and/or stiffness of the joint.
  • Increasing pain symptoms at rest.
  • For long-term wear: overstretching or abnormal thumb position.

Treatment

Based on your pattern of symptoms and the physical examination, the (plastic) surgeon may decide to order an X-ray in case of suspected wear and tear of the thumb base joint. Sometimes additional examination is needed in the form of a CT scan. However, your symptoms are leading for the (plastic) surgeon.

Treatment for Osteoarthritis of the base joint of the thumb:

Osteoarthritis cannot be cured. Treatment is therefore mainly aimed at eliminating the pain symptoms so that the hand can be used more effectively again. In addition, treatment also focuses on improving strength and mobility

Non-surgical treatment (conservative treatments)

Non-surgical treatment options are preferred in the early stages and may include:

  • Rest
  • Analgesics (NSAIDs);
  • Injection of an anti-inflammatory drug (corticosteroid) into the joint gap;
  • A (removable) splint;
  • Exercise therapy with a hand physiotherapist.

The combination of splint and hand therapy has a high success rate where surgery may be avoided for the patient. You should have followed this therapy for at least three months before your doctor can make a judgement on whether it has worked for you.

Surgical treatment

Pain and the degree of functional impairment is the main indicator for any surgical treatment. Surgical treatment is chosen when there is advanced wear and tear or when symptoms do not respond to conservative treatments. During surgery, the plastic surgeon removes the worn thumb base joint (the trapezium bone). Part of a tendon from the forearm is used to re-strengthen the thumb. After this operation, the thumb's mobility and strength will be less than before (before the wear and tear). However, pain is likely to decrease significantly.

Reimbursement and prices

Your visit to Parkway Clinic Sommer is regularly reimbursed in the same way as a visit to the hospital. For this, check our fees page or if you have any questions, take contact with us.

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