is the most common location for arthritis in the hand is due to wear and
tear with use of the thumb throughout the patient's years.
There is no cure
for arthritis but there is treatment falling into three categories; no
treatment, conservative, and surgery.
Surgery -- as the
last resort, when conservative treatment has failed -- consists of a joint
replacement using the patient's normal body tissues and involves excising
the arthritic bone and replacing it with a tendon taken from the wrist
which is rolled up into a ball and used as a spacer and a portion of it
is used to reconstruct the ligament. This is done through a small incision
at the base of the thumb and a smaller incision at the base of the wrist
to harvest the tendon used for the graft. It is an outpatient procedure
performed under axillary block where only the arm goes to sleep. The patient
is immobilized in a splint for two weeks, then a thumb spica cast for
two weeks and then uses a removable custom made splint for two months
while they are undergoing therapy for their thumb.
The first month is
to regain range of motion and the second month to regain strength. This
concludes a three month postoperative rehabilitation protocol. Patients
have a very good success rate with this surgery.
Before surgery is
considered, conservative treatment is attempted which is aimed at alleviating
the symptoms of arthritis. This consists of use of a splint, possible
anti-inflammatory medications, possible icing, and occasionally a cortisone
injection which usually give good but temporary relief.