Thumb Arthritis Arthroscopic Joint Resurfacing

Interposition arthroplasty

Thumb Arthritis Arthroscopic Joint Resurfacing is one of the most common surgeries done for arthritis of the Hand is for treatment of Thumb basal join arthritis.

As arthroscopic technology evolves, the access to smaller joints has lead to significant advances in development of arthroscopic techniques for treatment of thumb arthritis.

A.I.A (Arthroscopic Interpositional Arthroplasty)  at EHI:

  • Outpatient Procedure
  • Small 2 mm incisions
  • No Scars
  • Faster Recovery
  • Higher patient satisfaction
  • No thumb shortening
  • Less pain and stiffness
  • Better post op grip and pinch strength

There are numerous surgical techniques used for treating first CMC joint arthritis.

Open surgery VS endoscopic procedure:

Traditional Open surgery:

Most variants usually involve:

  • Two or sometimes three different open incisions
  • Complete removal of the arthritic bone (Trapezium)
  • Tendon removal from forearm used for thumb stabilization (ligament reconstruction)
  • Associated with different degrees of thumb shortening and weaker pinch strength.
  • Excellent pain relief

Arthroscopic procedure at EHI:

  • Done through two 2 mm incisions made along the thumb base joint line, a 1.9 mm scope allows magnified view of joint surface and surrounding ligaments. This view and additional live x-ray technology allow complete joint assessment and guidance for a targeted treatment.
  • Bone spurs and arthritic joint surface are debrided using a special small burr, increasing joint space and contouring a smooth joint surface.
  • Then, a special “collagen” Allograft patch is placed and used as joint interposition and resurfacing material to act as cushion between the bones.
  • Preserving the Trapezium bone (removed in traditional open surgery), helps maintain support to the thumb. This results in no thumb shortening and is usually associated with improved pinch strength.

Outcomes: Open Vs Endoscopic Surgery

Many research studies evaluating clinical outcomes have compared different surgical treatments for this condition to traditional open surgery. The specific benefits of arthroscopic procedure include:

  • faster recovery, less pain
  • less scar tissue formation
  • less stiffness, no need for tendon graft harvest
  • less thumb shortening, better pinch strength
  • greater patient satisfaction

Menon introduced the first thumb arthroscopic procedure in 1996

“Results revealed no loss in range of motion, an average increase in pinch strength in 20 of 31 patients, “no loss of preoperative range of motion, and subjective reports of no pain, or pain with exertional activities in 88% of patients”  (quote)   Menon J. Arthroscopic management of trapeziometacarpal joint arthritis of the thumb. Arthroscopy. 1996; 12(5):581–587. doi:10.1016/S0749-8063(96)90198-X [CrossRef]

“Within the past 2 decades, the arthroscopic treatment of carpometacarpal arthritis
has yielded satisfactory results, particularly with respect to pain relief”

Min Jung Park, MD, MMSc; Arthur T. Lee, MD; Jeffrey Yao, MD
Orthopedics
December 2012 – Volume 35 • Issue 12: e1759-e1764
DOI: 10.3928/01477447-20121120-21

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