Thumb base joint replacement

Procedure

In this procedure the joint at the base of the thumb is removed and replaced with a metal and plastic thumb joint – much like a small hip replacement. Historically joint replacements at the base of the thumb have not lasted a long time, but more modern designs are looking much more promising and provide better pain relief, grip strength and function than Trapeziumectomy. In the medium term the replacements seem to be lasting well with 98% lasting at least 4 years. However, we cannot say how long they will last for and if you opt for a joint replacement it is possible further surgery may be required in the future.

The operation itself takes around an hour and can be done under general anaesthesia – with you asleep; or under regional anaesthesia – with a numb arm. There will be a scar on the back of the thumb, typically around 4-5cm.

Aftercare

After the operation you will be in a cast for two weeks. After the first two weeks you will come back to have your stitches taken out and will be given exercises to get the thumb moving.  You may be referred for hand therapy if needed. Within six weeks most patients are able to return to most activities

Risks

Any procedure carries risks and whilst every care is taken to minimise the chances the following are some of the more common - but still rare  - complications that can arise:

Infection - Significant infection is very rare but if it does occur may require further surgery.

Stiffness, swelling and pain  - A degree of stiffness , swelling and pain following surgery is normal. Some people react badly to an operation and develop more of this. This in called complex regional pain syndrome (CRPS) and requires specialist treatment.

Failure - All artificial joints will eventually wear out.

Dislocation - In theory any artificial joint can dislocate. 

References

Jager, T., et al. "[Evaluation of postoperative pain and early functional results in the treatment of carpometacarpal joint arthritis. Comparative prospective study of trapeziectomy vs. MAIA (®) prosthesis in 74 female patients]."Chirurgie de la main 32.2 (2013): 55-62.

Kubát, P., and L. Trtík. "[Maia trapeziometacarpal implant for treatment of advanced osteoarthritis of the basal joint of the thumb]." Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca 79.6 (2011): 520-523.