Dr. Mark E. Pruzansky
Dr. Jason S. Pruzansky
975 Park Avenue New York, NY 10028

Basilar Joint of the Thumb Arthroscopic Surgery

What is Basilar Joint of the Thumb Arthroscopic Surgery?

Basilar Joint of the Thumb Arthroscopic Surgery is a known surgical option for the treatment of arthritis of the joint where the thumb meets the wrist— also known as the trapeziometacarpal joint. Mild cases are performed arthroscopically. In moderate to severe cases, this procedure involves reconstructing the joint. The procedure is outpatient. Usually, the patient is awake and receives a regional block with sedation available.

Following surgery, the thumb is immobilized and a padded splint is applied to promote healing. Patients experience discomfort and swelling after the procedure. Analgesics and elevation of the hand are employed.

Conditions that can be Helped by a Basilar Joint of the Thumb Arthroscopic Surgery?

Basal joint arthritis occurs when the cartilage of the carpometacarpal is damaged or wears away from the bone. This cartilage acts as a cushion between the bones of the joint. When it is damaged or wears away, it causes direct friction between these bones, causing decreased range of motion, swelling, and pain. Patients who complain of pain, stiffness, and swelling below the thumb, will require an X-ray after a physical examination. This helps to evaluate the condition of your bones and joint.

Osteoarthritis of the thumb is the primary reason for this procedure, followed by rheumatoid arthritis. However, daily activities including the thumb will contribute to the wear and tear of this joint. Some patients may experience arthritis in this joint and not in their other joints with bilaterality being quite common.

Impact injuries damaging the joint can also be a factor in considering this procedure.

Activities involving grasping or pinching and flattening the hand with pressure may cause overuse injuries in an arthritic joint contributing to the frequency of this procedure. Because of the thumb’s great range of motion and the natural dexterity of the thumb, there is an increased risk of painful osteoarthritis in the first carpometacarpal (CMC) joint, where the thumb meets the trapezium bone in the wrist. Outside of trauma and autoimmune causes, genetics play a major role in causing basal joint osteoarthritis.

What Does a Basilar Joint of the Thumb Arthroscopic Surgery Entail

Arthroscopic surgery is typically performed on an outpatient basis. The required treatment will be based on the patient’s specific needs. The procedure involves debriding existing tissue damage. In other patients, arthroplasty may be used to reposition and repair ligaments to reconstruct the joint using the patient’s own tissues.

The most common treatment for basilar joint conditions include:

  • Arthroplasty: the arthritic part of the basal joint is removed and replaced with a graft taken from one of the patient’s native tendons.
  • Trapeziectomy: removal of the trapezium, one of the key bones in the thumb joint, and restructing the ligaments.
  • Osteotomy: the bones will be repositioned to the joint to correct alter pressure on the arthritic joint.
  • Arthrodesis: this procedure permanently fuses the joints together at the basal joint, which increases stability and reduces pain.

In milder cases, the procedure will be carried out with minimally invasive surgery with a technique called arthroscopy. This is performed using an arthroscope, which is an endoscope that is inserted into the joint via a small incision. This technique generally has faster healing times due to the use of smaller incision sites and limited surgery.

Recovering from a Basilar Joint of the Thumb Arthroscopic Surgery

Arthroscopic joint repair requires a brief period of immobilization followed by occupational therapy to improve dexterity, strength, and range of motion. Many patients may benefit from several months of exercises. Many patients will continue to improve for many months following the surgery and are able to use their thumbs again with little or no pain.

Following treatment, the patient will be required to wear a cast or a splint over the thumb and/or wrist. This period will last for up to five weeks in reconstruction cases. Less splinting is needed in arthroscopy cases. After the cast or splint is removed, a period of physical therapy for a few months is recommended in order to help the patient regain strength and range of motion which were reduced prior to surgery.

If You are Experiencing Hand Pain, Contact HandSport Surgery Institute.

Please contact us as soon as possible to schedule an appointment with our talented team. People who have hand pain should be evaluated to try and prevent further injury and mobility issues. If you have been injured, it’s important to be evaluated by a highly skilled professional. Call Drs. Mark and Jason Pruzansky at 212-249-8700 to schedule an appointment and obtain an accurate diagnosis.