Basilar Thumb Arthritis – LewisGale Medical Center

(Lighthearted music) – My name is Micah Jones. I am a Orthopedic Surgeon
at LewisGale Hospital. I subspecialize in adult
hand and upper extremity. As well as I, do all the
pediatric hand and upper extremity for the hospital and
the surrounding areas. Basilar thumb pain is usually
a patient that comes in saying their thumb is hurting in
this region right here. And it’s usually exacerbated by writing, pinching,
gripping, or opening jars. Very commonly seen in females in the 50s and 60 age population. It can be a very painful condition that inhibits patients from doing
their normal day to day tasks. Such as even opening a door because the key pinch is so painful when
they are doing this maneuver that it puts significant pressure
on the base of the thumb. So this is a hand, and this is showing the base of the thumb. And really this model is just
demonstrating the fact that the joint has worn out, and because of the loose of cartilage, the bone starters to
form these bone spurs. And very commonly the patient will come in and they’ll have this bump
on the back of their hand. And the bump on the back of
their hand will be right here, and commonly people think
their thumb is dislocated, but really all it is, is a
significant bone spur that’s caused from the severe arthritis. Because as the body
forms these bones spurs, this model actually
demonstrates this quite nicely, the bone starts to shift this way, and as it shifts this way it causes a bump on the back of the thumb. And that bump is very common
and it’s very painful. How do we diagnose
basilar joint arthritis? Pain in the base of the thumb, pain with a pinch, grip, opening jars, things of that nature. So, when a patient is referred
to me for thumb arthritis, I always get an x-ray of their thumbs and then I go over the x-rays with the patient in the office. Then we talk about treatment options. Treatment options for
basilar thumb arthritis are conservative at first. Splinting the thumb, holding the thumb in a position like this can help prevent the pain because you’re preventing the pinch. I also start the patients on anti-inflammatories, Advil, Aleve, or even prescription
strength anti-inflammatories. Other than oral medication, I inject this joint quite often, and that can be very pain
relieving to patients. Specifically, because the
bone-on-bone arthritis is so bad that the steroid shot can
give them significant relief. Therapy for this condition
is not very beneficial, because once the arthritis
has gotten so far along that doing any particular range
of motion or strengthening usually just exacerbates the therapy, so. Surgical options after they have failed conservative management including injections, splinting,
and activity modification, would be replacing the
base of the thumb joint. Surgery for basilar joint arthritis is usually a joint replacement surgery. The benefit of the thumb
replacement surgery for this particular arthritis is, there’s no metal components, there’s no implant that requires cement like a total knee replacement or total shoulder or a total hip. All of the stuff that I
use is your own tissue. This surgery is an outpatient surgery; it takes about two hours. You’re gonna splint
for the first two weeks and then a short arm thumb spica cast for an additional three to four weeks. I always tell my patients
after thumb replacement surgery that it takes about three months to get 80% of their recovery, and it takes up to 12
months to that extra 20%. So usually patients are feeling
pretty much back to normal around the three month mark, but it really takes quite some time to feel like they are back
to normal, quote unquote.

1 thought on “Basilar Thumb Arthritis – LewisGale Medical Center

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