Arthritis Thumb – Trapeziectomy

Arthritis can affect any moving joint in the body when the smooth surfaces inside the joint become roughened and worn. Normal, smooth joint surfaces have a healthy cap of cartilage on the end of bones and when this is worn away, the bare bone ends rub against each other causing combinations of pain, swelling, stiffness and deformity in the joint.

It is very common for the joints at the base of the thumb to become arthritic.  The pain from the arthritis causes patients to avoid activities or to grip objects only weakly.  This is highly inconvenient for patients as many simple daily activities are difficult.

Treatments for arthritis in the thumb may initially include splints or steroid injections but often these provide only temporary relief.

Where pain is significant and persistent and is significantly affecting function, it is possible to achieve long term pain relief and improvement in function with a simple day case operation called trapeziectomy.  This operation removes a small bone at the base of the thumb and takes 2-3 months to recover from.  During this time, gentle, progressive return to normal activity is encouraged.  After 3 months, 90% of patients will have little or no arthritis pain.  


 trapeziectomy thumb arthritis harley

Hello Mr Harley, as promised on Monday, some words about my trapeziectomy and the experience.  Please do let me know if its adequate, very happy to amend, add etc.

 I wasn’t aware of a trapeziectomy until I met Mr Harley at KIMS hospital in Maidstone.  What I was aware of was increasing pain and debilitation in my hands and forearms which was impacting on my general demeanour and activities more and more.  Cooking, exercise, writing and tasks that required thumb dexterity and strength were becoming increasingly painful.

 At my first appointment with Mr Harley, after consultation and explanation, I was given a steroid injection as an initial course of action.  The benefits whilst very noticeable were short lived and I was aware that this wasn’t a long term solution.  Mr Harley explained in detail at the second appointment further options, one of which was the trapeziectomy.  Although a little anxious about having an operation, I opted for this procedure and took away the written information he provided to help prepare me. 

 On the day of the operation the staff at KIMs made me very welcome and put me at ease, always smiling and explaining each step and each process.  The operation was over extremely quickly.  I was taken to theatre around 5pm and home just after 7pm.  I received excellent care throughout.  I wore a cast for 2 weeks after which I saw the hand therapist.  I am a little squeamish and was reluctant for the dressing to come off, but Ellie, the therapist was gentle and understanding and I didn’t feel a thing, the scar was and is amazingly small and neat.   I was given a custom made splint which allowed some limited movement.  I’ve continued to see Ellie several times and will do in future for hand exercises all of which have significantly and rapidly improved the movement, scarring and use of the thumb and hand.  There are some limitations in use of the hand in the first 8 weeks following the operation but I was surprised how the body adjusts and one finds alternative ways of doing things.  I noticed improvement week on week whether that was being able to wash my hair, prepare food, use a keyboard and finally driving.

 The information, care and post-operative care I have received from Mr Harley, KIMs staff and the hand therapists has been excellent throughout.   I have not experienced any pain at all from the time I woke up from the operation and have taken no pain medication.  It’s been 3 months since I had the operation, my hand looks and feels fine the mobility and strength continue to grow, it’s amazing.  Would I do it again………………………… the blink of an eye and hopefully in July when I will be having a trapeziectomy on my other hand so that the pain is gone and my hand will be in good working order with full use.

 TS.   Maidstone

In the video, the left thumb has had trapeziectomy 3 months ago and the right thumb was treated a year previously.  Normal, pain-free function has been restored.

I don't have the pain any more.  I can't thank you enough.......and nobody could believe the neat GP said there was nothing that could be done.  DF. East Sussex.  Only 8 weeks after trapeziectomy.