Osteoarthritis (OA) is the “wear and tear” form of arthritis we all suffer from as we age. The saddle joint at the thumb base is the most common site of OA, a condition known as basal joint OA or OA of the first carpometacarpal joint. The condition is more common in women, but it is present in significant numbers in both genders.
In the early stages, OA symptoms are associated with activities such as turning a key or opening a jar. As the condition worsens, pain may develop at rest and not be associated with symptom-provoking tasks. Over time, the joint may partially dislocate and the thumb may develop deformity and limited motion. Some patients with minimal deformity will experience significant symptoms and other patients with severe deformity may have little associated pain.
The diagnosis of OA is made by a physical examination of the involved joint, as well as x-rays. The condition frequently occurs in both thumbs, where there may be a familial predisposition. Treatment is tailored to the patient’s symptoms. Patients having slight pain, despite deformity and severe x-ray changes, usually do not require medical intervention.
Patients with pain may find long-term relief from a cortisone injection in the joint. The injection may be repeated as required on an occasional basis. Wearing a thumb splint helps ease discomfort while the splint is being worn. However, pain may return with removal of the splint. Cortisone injections may become ineffective over time.
Some patients will require surgery to manage recalcitrant symptoms. The surgery is usually done as an outpatient procedure with regional anesthesia. Rarely, the joint is fused. More often, surgery for basal joint OA involves removal of the trapezium, the smaller wrist bone at the thumb base. Stability may be maintained with a tendon and sometimes a temporary pin. Unlike many artificial joint replacements, most basal joint arthroplasties do not wear out over time as the reconstruction involves the patient’s own tissue. In cases where deformity has developed in adjacent joints, surgery may be done at those sites. The patient’s thumb and wrist are immobilized in a splint or cast for about four weeks and upon removal of support, occupational therapy is instituted with a certified hand therapist to regain motion and strength. Most patients experience significant long term pain relief and an increase in pinch strength.
Many patients with basal joint OA are treated at OrthoGeorgia and though many of these patients do not require surgery, hundreds annually undergo surgery for this common and frequently painful condition.
Dr. Waldo Floyd III is one of our Fellowship Trained hand surgeons at OrthoGeorgia, certified in both Orthopaedic Surgery and Surgery of the Hand by the American Board of Orthopaedic Surgery. Dr. Floyd provides hand surgery and care to patients of all ages at our office in Macon, GA, diagnosing and treating hand conditions and injuries of all kinds. He has been a Consultant Reviewer for the Journal of Hand Surgery for over twenty years and has authored a variety of peer reviewed articles. Dr. Floyd has also held many leadership positions in his field and is a member of the American Orthopaedic Association.
At OrthoGeorgia, we are proud to provide personalized care for all manner of orthopaedic hand and upper extremity issues, including osteoarthritis. Our team of orthopaedic hand specialists will work with you to determine the cause of your pain or discomfort and create a care plan based on your unique needs. We provide a comprehensive, patient-centered approach to restore optimal function and use of the hand and upper extremity. If our specialists feel that hand therapy is the best next step for you, we will gladly refer you to one of our occupational therapists or certified hand therapists at OrthoGeorgia. Along with hand care, our specialties include spine, sports medicine, foot & ankle, and total joint care, which we provide at our offices in Macon, Macon Spine and Orthopaedic Center, Warner Robins, Kathleen, Milledgeville, and Dublin, GA. To learn more about how we can help you or to schedule an appointment, please contact OrthoGeorgia today!
At OrthoGeorgia, we want to help you live a healthier and more comfortable life by giving those in Macon, Warner Robins, Kathleen, Milledgeville, Dublin, and the surrounding areas convenient access to the highest quality care. Whether you have been suffering from a sports injury or a common orthopaedic condition, we will determine the cause of your discomfort and craft a personalized treatment plan to bring you relief. To learn more about our services and our physicians, or to schedule an appointment at OrthoGeorgia, please contact us today.