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Orthopedics · Hand and wrist

Arthritis of the thumb and fingers

Does it hurt at the base of your thumb when you turn a key or open a jar? When pain at the base of the thumb limits everyday activities, surgery on the joint can relieve it. Worn finger joints can be treated in a similar way. If everything is in order, the procedure can take place as soon as within a week of the consultation.

Book an orthopedic consultation How the procedure works
  • No referral from a general practitioner needed
  • Surgery by Prof. MUDr. Radek Hart

Day surgery procedure

1 weekhow soon the procedure can take place
going home
same dayusually, day surgery procedure
to the procedure
1 weekfrom the consultation, if everything is in order
after surgery
4–8 weekscast or brace, depending on the type of procedure
grip strength
12 monthsit can keep improving this long after surgery

When a procedure is considered

Pain at the base of the thumb and stiff fingers

It lets the thumb rotate and grip, for example when you hold something between the thumb and fingers. The ends of the bones are covered with smooth cartilage. In arthritis (at the thumb it is called rhizarthrosis) the cartilage gradually wears away, the bones begin to rub against each other and the joint hurts. Arthritis at the base of the thumb is very common and usually develops gradually.

  1. Pain when gripping and turning

    It hurts at the base of the thumb when you hold something between your fingers, turn a key or open a jar. The pain may persist after longer use of the hand and also appear at night.

  2. Weaker grip and a bump

    The grip weakens, and the base of the thumb swells and is tender to the touch. A bump may appear, which is a bone spur, and the thumb moves less than before.

  3. Who is at higher risk

    Women, who get it two to three times more often than men, people over 50, with cases in the family, who are overweight, after an injury to the thumb or wrist and with looser joints. Work that involves a strong grip or lifting, and smoking, also raise the risk.

  4. Arthritis of the finger joints

    The small finger joints can wear out too. They hurt mainly after exertion, sometimes only hours later, in the morning the fingers are often stiff and the joints swollen or enlarged. At the end joints, small cysts can form that cause grooves in the nail.

Diagram of the base of the thumb of the right hand from the back of the hand: between the trapezium bone and the first metacarpal bone is a joint with cartilage and an open joint spaceHealthy thumb base jointfirst metacarpalbonecartilage inthe thumbbase jointtrapezium boneradius Diagram of the same place in arthritis: the cartilage is worn, the joint space narrowed, the joint loses its shape and a bone spur has formed at the base of the thumbArthritis of the thumb base jointthe joint losesits shapecartilage is worn,joint spaceis narrowingbone spur:bump at thebase of the thumb
  • outline of the hand
  • bones
  • cartilage in the thumb base joint
  • worn joint
Simplified diagram of the base of the thumb of the right hand from the back, not an actual image.

When to operate

When surgery is appropriate

Surgery is considered according to how much pain and a weak grip limit you in everyday life. Whether and when to operate is decided by the doctor at the consultation.

Symptoms

Pain limits everyday activities

When the pain does not subside.

  • It hurts when gripping, turning a key or opening a jar
  • The pain persists after longer use of the hand and also appears at night

Function

The hand stops doing its job

When the grip weakens.

  • The grip is weak and things are harder to hold
  • The thumb moves less than before

Choice

Surgery to suit your needs

We choose the approach together with you.

  • Prof. Hart judges from the examination and X-ray how worn the joint is
  • We choose the type of surgery according to the findings and how you need to use the hand

Which operations come into question

There are several operations for the thumb base joint. According to research, none of them is clearly better than the others in relieving pain and in hand function. Prof. Hart will go over with you which one suits your findings and how you need to use the hand.

  • Removal or replacement of the trapezium bone

    The small wrist bone at the base of the thumb is removed. The pain subsides and the thumb stays mobile. Depending on the findings, the small bone is only removed or it is replaced; sometimes the thumb is also supported with a tendon.

  • Arthroplasty of the thumb base joint

    The damaged part of the joint is removed and the thumb is suspended using a tendon from the wrist or using a medical device. This relieves the pain and the thumb keeps moving.

  • Thumb base joint replacement

    The damaged part of the joint is replaced with an implant made of metal, or of metal and plastic, and the joint stays mobile. Newer implants have promising early results, but less is known about long-term results so far.

  • Arthrodesis (fusion) of the thumb base joint

    The joint surfaces are removed and the bones are secured so that they fuse into one. The pain subsides and the grip is strong, but the thumb no longer moves at this joint.

  • Finger joint replacement or fusion

    For worn finger joints, the first consideration is whether the joint can be preserved. When the joint surfaces no longer work, the joint is replaced with an implant that preserves motion, or the joint is fused. Fusion relieves the pain, but the joint then stops moving. The long-term results of joint replacements in the hand are not yet fully known.

Not sure whether surgery is right for you? The examination decides. Book a consultation

How the procedure works

From booking to going home

Surgery on the thumb base joint and on the finger joints is done as day surgery, and you usually go home the same day. Which procedure is suitable for you will be explained by Prof. Hart after the examination and X-ray.

  1. Booking

    Online or by phone. A referral from a general practitioner is not needed.

    online or by phone

  2. Consultation and examination

    Prof. Hart examines the hand, tests the motion and sensitivity of the joint and judges from the X-ray how worn the joint is. He also checks whether you have carpal tunnel syndrome at the same time.

    diagnosis and treatment plan

  3. Procedure

    Under anesthesia. How long the procedure takes depends on the chosen operation.

    as soon as within a week of the consultation

  4. Going home

    Usually on the day of the procedure, with a cast or brace that protects the operated joint.

    follow-up and physiotherapy

Recovery and physiotherapy

The hand recovers gradually

After surgery you wear a cast or brace for 4 to 8 weeks, depending on which procedure you had. Full recovery takes several months. Physiotherapy helps restore the motion and strength of the hand, right at the clinic if needed.

Room in the short-stay ward of HR Clinic

  1. The first 4 to 8 weeks

    The cast or brace protects the operated joint until it has healed. Go easy on the hand as the doctor instructs and come to the follow-up visits as arranged.

  2. Physiotherapy

    A physiotherapist helps you restore the motion and strength of the hand. At first the hand may hurt during exercises, and that improves over time.

  3. Grip strength up to a year

    Grip strength keeps improving for 9 to 12 months after surgery. Most people return to their usual activities.

  4. Finger joints

    After surgery on a finger joint, people usually return to most activities after about 3 months. The length of recovery depends heavily on the extent of the procedure, though.

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Who operates

Prof. MUDr. Radek Hart, Ph.D., FRCS, MHA

Orthopedic and trauma surgeon of the musculoskeletal system, head physician of HR Clinic. He sees patients in Znojmo and in Vienna; after a consultation in Vienna the procedure can be carried out in Znojmo.

More about Prof. Hart Professional site ortho-hart.at

Price We will tell you the price of the procedure at the consultation, depending on the findings and the extent of the procedure.

Frequently asked questions

What patients ask most often

Related articles and procedures

Painful finger joints: arthritis and treatment Carpal tunnel surgery Wrist surgery Minor procedures on the hand
How long will I wear a cast or brace after surgery?

Usually 4 to 8 weeks, depending on which procedure you had. Grip strength then keeps improving for another 9 to 12 months after surgery.

Which operation will you recommend for me?

It depends on how worn the joint is, how much thumb motion you need and how you use the hand. According to research, none of the operations is clearly better than the others, so we choose the approach together with you at the consultation.

Will the thumb stay mobile?

After removal of the trapezium bone, after arthroplasty and after joint replacement, yes. After arthrodesis (fusion) the thumb no longer moves at the base joint, but the grip is strong.

My fingers tingle too. Is it related to the thumb arthritis?

Tingling in the fingers is often caused by carpal tunnel syndrome, which many people with thumb arthritis have at the same time. We therefore look for it during the examination as well. More on the page Carpal tunnel surgery.

How long will I stay at the clinic?

You usually go home on the day of the procedure. The stay at the clinic lasts 24 hours at most.

Do I need a referral from a general practitioner?

No. Just book online or by phone.

How soon can I have the procedure?

If everything is in order, the procedure can take place as soon as within a week of the consultation. We will arrange the date according to the result of the examination.

Booking

Book an orthopedic consultation

Online or by phone, at the clinic in Znojmo. A referral from a general practitioner is not needed.

Book a consultation
Book a consultation