Acta clinica Croatica, Vol. 63. No. 2, 2024.
Review article
https://doi.org/10.20471/acc.2024.63.02.16
Surgical methods in the treatment of basal thumb arthritis – from arthroscopy to arthroplasty
Zoran Sulje
; Department of Orthopedic Surgery, Zagreb University Hospital Center, Zagreb, Croatia
*
Damir Starčević
; Akromion Special Hospital for Orthopedic Surgery, Krapinske Toplice, Croatia
Ana Aljinović
; Department of Orthopedic Surgery, Zagreb University Hospital Center, Zagreb, Croatia
Katarina Barbarić Starčević
; Department of Orthopedic Surgery, Zagreb University Hospital Center, Zagreb, Croatia
* Corresponding author.
Abstract
The first carpometacarpal joint is the second most common joint affected by
degenerative arthritis. The prevalence of the first carpometacarpal joint arthritis increases with age,
especially in postmenopausal women. Ligamentous laxity or injury of the first carpometacarpal joint
is thought to be the starting point of development of degenerative changes, accompanied with altered
biomechanics of the thumb. As the disease progresses, the joint is destroyed and the thumb and
hand function are deteriorating. Although many patients, in different stages of disease, experience
pain relief with conservative treatment, surgery is often needed. Decision on the type of surgical
procedure depends on the age of the patient, functional demands, and stage of the disease. In early
stages of the disease, stabilization of the first carpometacarpal joint, extension osteotomy of the first
metacarpal and arthroscopic procedures are used. Th ese are joint-preserving procedures, and they slow
down progression of the disease and reduce symptoms. In late stages of the disease, joint arthroplasty
procedures and first carpometacarpal arthrodesis are performed. In recent years, late stages of the
disease can also be treated arthroscopically. This paper describes different surgical methods, their
advantages and drawbacks, with respect to different stages of the disease.
Keywords
Hand; Thumb; Rhizarthrosis; Carpometacarpal joint; Osteoarthritis; Surgery
Hrčak ID:
328139
URI
Publication date:
31.10.2025.
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