There are several factors which contribute to osteoarthritis but 50% of the risk is thought to be inherited.

Women are at least 3 times as commonly affected. Hormonal changes around the menopause are thought to play a role in loosening the supporting ligaments of the joint.

Old injuries to the thumb including fractures, dislocations or ligament tears can alter joint mechanics and accelerate cartilage wear, leading to post-traumatic arthritis.

Wear and tear plays a role. Thumb arthritis affects patients from a range of jobs and careers but it is probably the case that frequent, forceful use of the thumb over many years will contribute to joint degeneration.

Osteoarthritis is the usual type of arthritis which affects the thumb but it can occasionally be affected by rheumatoid arthritis

Thumb arthritis is condition where the cartilage degrades with time and use. It is most commonly encountered between the ages of 50 and 70.

Both procedures are effective at relieving pain and outcomes in terms of function and pain relief are the same once healing recovery is completed. Joint replacements recover more quickly (i.e. there is less post surgical pain and swelling) and no shortening of the thumb is expected but they have a higher rate of re-operation in the future and they only treat arthritis arising in the distal joint of the trapezium (CMC joint).

Your thumb will be in a plaster cast or splint for 2 weeks. The splint is only across the wrist and around the thumb. You can use the hand for gentle activities within the confines of the splint. The hand therapist will see you during the first fortnight from operation, remove the splint and make a more practical splint which can be removed. During the 2 months following you will have a progressive programme of exercises to to help recovery and you will use the splint less and less as you recover movement and strength. Most patients can perform light activities with the hand at around six weeks. Surgical pain settles but this is typically quite strong for the first 2-3 months. After 3 months there will be no restriction of activities and most patients will be realising the benefit of operation with less pain and improving function. Full recovery tends to be reached some time between 6-12 months after surgery.

Removing the trapezium bone means the thumb column shortens slightly — typically by around 5 mm. This is usually not noticeable in everyday appearance or function. Suspension techniques used during surgery help maintain the height of the metacarpal during the healing phase.

After trapeziectomy the bone is gone permanently, so the original arthritis cannot recur. Occasionally patients develop discomfort at adjacent joints over the longer term. After joint replacement, implant wear or loosening is possible and approximately 10% of cases may need further surgery by 10 years.

Patient satisfaction and function rates after trapeziectomy are high and it is considered to be at least 90% successful, with patients typically experiencing significant or complete pain relief and improved function. Most people return to a wide range of activities they had previously found difficult. Results after joint replacement are similarly good.

Both trapeziectomy and joint replacement can be performed under a regional nerve block (the arm is asleep but you are awake) or under a short general anaesthetic.

This depends on the nature of your work. Light activities can be commenced straight away; if you have a reasonably relaxed office job or work from home, you could potentially be back at work within a few days. Those whose work is very repetitive or forceful will need to take at least 2 months off work or with amended duties. It is unlikely you will be able to drive for approximately 4 weeks.