What thumb arthritis surgery entails depends on the severity and stage of the arthritis and can involve the restoration of ligaments, the movement of tendons, replacement of the joint or fusion of the joint, states Arthritis Foundation. Different procedures have different benefits and difficulties associated with them, and patient preference is also an element in deciding which procedure to use.
The joint where the thumb bones meet the wrist is very flexible relative to the other fingers, but it is also at a greater risk of developing arthritis, Arthritis Foundation explains. When the ligament at that joint is most affected and the cartilage is intact, ligament reconstruction alone may be sufficient. In this procedure, the existing damaged ligament is replaced with a piece of the wrist flexor tendon. For cases where the cartilage is damaged, surgeons can also replace the joint with a pad of rolled-up tendon or an artificial pad. Using the tendon requires that surgeons first remove the trapezium bone or a portion of it.
A relatively simple procedure for moderate to severe arthritis is hematoma and distraction arthroplasty, says Arthritis Foundation. In this operation, surgeons remove the trapezium bone and install a wire to immobilize the thumb joint for six weeks. This gives the joint time to heal itself. Surgeons can also replace the joint entirely with an artificial joint or padded spacer, or fuse the wrist bone to the thumb bone, eliminating the joint completely.