Base of Thumb Joint Replacement:
- chris phoon
- Oct 11
- 2 min read
New treatments for Thumb Arthritis
By Dr Christopher M. Phoon
MBBS BSc(Med) FRACS(Orth) FAOrthA
Orthopaedic Surgeon, Queenstown Joint Clinic
A Modern Option for Thumb Arthritis
Arthritis at the base of the thumb (the carpometacarpal or CMC joint) is a common cause of hand pain and weakness.For decades, the standard operation was trapeziectomy – removing the small trapezium bone, sometimes with tendon stabilisation.
In recent years, a growing alternative has emerged: total joint replacement, designed like a miniature hip replacement, using a ball-and-socket implant similar to hip replacement
How Long Has This Been Around?
Modern thumb joint replacements are now quite successful. Earlier designs had mixed results, loosening or dislocation with problems such as loosening and dislocation. newer implants however have evolved over several decades.
A 2021 systematic review covering more than 3,000 implants reported follow-up to 13 years with encouraging results.
Norwegian registry study on thumb CMC replacements (479 implants) reporting 10-year implant survival of ~90%. link
While long-term data aren’t as extensive as for hip or knee replacements, the evidence suggests these prostheses are durable for most patients.
Function Compared with Trapeziectomy
A 2021 meta-analysis found that patients who had a joint replacement often reported better hand function and pinch strength, while pain relief was similar to trapeziectomy.
Replacement also helps preserve thumb length and alignment, leading to faster early recovery.
Key Takeaways for Patients
Thumb CMC joint replacement is now an established and evolving treatment.
10-year survival in many modern designs is around 90 %.
Function and strength are often as good as, or better than, trapeziectomy.
Trapeziectomy remains a low-risk option with a long track record. It is a good fallback position for revision surgery.
The right choice depends on age, bone quality, activity level.
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