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J Am Acad Orthop Surg, Vol 16, No 3, March 2008, 140-151.
© 2008 the American Academy of Orthopaedic Surgeons
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Thumb Carpal Metacarpal Arthritis

Ann E. Van Heest, MD and Patricia Kallemeier, MD

Dr. Van Heest is Associate Professor, Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN. Dr. Kallemeier is Orthopaedic Surgeon, Des Moines Orthopaedic Surgeons, PC, Des Moines, IA.

None of the following authors or a member of their immediate families has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Van Heest and Dr. Kallemeier.

Reprint requests: Dr. Van Heest, Department of Orthopaedic Surgery, University of Minnesota, Suite 200, 2450 Riverside Avenue, Minneapolis, MN 55454.

The thumb carpometacarpal (CMC) joint is the most common site of surgical reconstruction for osteoarthritis in the upper extremity. In patients older than age 75 years, thumb CMC osteoarthritis has a radiographic prevalence of 25% in men and 40% in women. The thumb CMC joint obtains its stability primarily through ligamentous support. A diagnosis of thumb CMC arthritis is based on symptoms of localized pain, tenderness and instability on physical examination, and radiographic evaluation. A reproducible radiographic classification for disease severity is based on the four-stage system described by Eaton. Nonsurgical treatment options include hand therapy, splinting, and injection. Surgical treatment is tailored to the extent of arthritic involvement and may include ligament reconstruction, metacarpal extension osteotomy, arthroscopic partial trapeziectomy, implant arthroplasty, and trapeziectomy with or without ligament reconstruction and tendon interposition.






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Copyright © 2008 by the American Academy of Orthopaedic Surgeons.