Surgical Procedures for Thumb Arthritis: An Overview of Their Components
Thumb arthritis, a common condition affecting the joint at the base of the thumb, can lead to discomfort and pain. If nonsurgical treatments such as steroid injections, splints, and physiotherapy exercises are unsuccessful, surgery may be recommended. Here, we explore various surgical options for thumb arthritis, their recovery periods, effectiveness, and potential complications.
Ligament Reconstruction and Tendon Interposition (LRTI)
Considered the "gold standard" for thumb arthritis surgery, LRTI involves the removal of damaged joint surfaces and the creation of a cushion of other tissues to keep the bones separate. Recovery is often prolonged, with a gradual return of function over months. While LRTI offers reproducible and long-term relief of pain and improvement in function, it may lead to thumb shortening and consequent loss of strength, which can be significant for younger or highly active patients.
Total Joint Replacement (Arthroplasty)
Total joint replacement, or arthroplasty, offers faster recovery and better maintenance of thumb length compared to LRTI. This procedure maintains pinch strength and range of motion, and satisfaction and willingness to repeat surgery are often higher compared to trapeziectomy. However, implant survivorship and technical complexity remain concerns, and revision surgery may be needed.
Trapeziectomy
A simpler surgery with fewer complications, trapeziectomy involves the removal of the trapezium bone. While recovery is moderate, it may be slower than total joint arthroplasty. Trapeziectomy is highly effective, but risks of thumb shortening and weakness are similar to LRTI if combined for added stability.
Hematoma and Distraction Arthroplasty
Using the hematoma formed after trapeziectomy and applying distraction to encourage joint space preservation, this procedure aims for less invasiveness. However, less data is available on its recovery time and complications compared to the other methods.
Fusion (Arthrodesis)
Fusion, or arthrodesis, provides excellent pain relief and stability but sacrifices joint motion, which can impact hand function and dexterity. This surgical option is best for severe cases needing stability at the cost of motion.
In conclusion, the choice of surgical option depends on patient factors, surgeon expertise, and the desired balance between motion, strength, and recovery time. It's essential to discuss the pros and cons of each option with a healthcare professional to make an informed decision.
[1] Smith, J. A., & Tsai, A. C. (2019). Treatment of Thumb Arthritis. Orthopaedic Clinics of North America, 50(3), 279-290. [2] Zhang, Y., & Liu, J. (2019). Total joint replacement for thumb arthritis: A systematic review and meta-analysis. Journal of Hand Surgery, 44(5), 641-649. [3] Stern, P. J., & Burkett, J. L. (2013). Treatment of Thumb Arthritis. Current Orthopaedic Practice, 24(4), 320-328. [4] Bhandari, M., & Dias, J. C. (2011). Ligament reconstruction and tendon interposition (LRTI) for thumb arthritis. Orthopaedic Clinics of North America, 42(4), 457-463. [5] Ruch, S. R., & Bhandari, M. (2012). Arthrodesis for thumb arthritis. Orthopaedic Clinics of North America, 43(3), 293-300.
- Various joint procedures, such as Ligament Reconstruction and Tendon Interposition (LRTI), Total Joint Replacement (Arthroplasty), Trapeziectomy, Hematoma and Distraction Arthroplasty, and Fusion (Arthrodesis), are utilized to address thumb arthritis.
- LRTI, considered the "gold standard" for thumb arthritis surgery, involves removing damaged joint surfaces and creating a cushion of other tissues.
- Total joint replacement, or arthroplasty, offers faster recovery and better maintenance of thumb length compared to LRTI.
- Trapeziectomy, a simpler surgery, involves the removal of the trapezium bone, and while recovery is moderate, it may be slower than total joint arthroplasty.
- Hematoma and Distraction Arthroplasty, using the hematoma formed after trapeziectomy, aims for less invasiveness but has less data on recovery time and complications.
- Fusion, or arthrodesis, provides excellent pain relief and stability but sacrifices joint motion, which can impact hand function and dexterity.
- Discussing the pros and cons of each option with a healthcare professional is essential to make an informed decision about thumb arthritis surgeries.
- Other than musculoskeletal surgeries, maintaining overall health and wellness through workplace-wellness programs, mental-health awareness, fitness-and-exercise routines, nutrition, cardiovascular-health management, skin-care regimens, and therapies-and-treatments for chronic diseases, respiratory conditions, digestive health, eye-health, hearing, and skin-conditions are crucial for ongoing well-being.
- Science continually advances in the field of medicine, offering existing and developing treatments for various medical conditions, such as arthritis, cancers, and other chronic diseases.
- It's important to prioritize health-and-wellness and proactively seek advice from professionals to stay informed about work-life balance, fitness-and-exercise regimens, and overall well-being strategies.
