What is Carpometacarpal Arthroplasty?

Carpometacarpal (CMC) arthroplasty is a surgical procedure used to treat advanced arthritis of the thumb joint—specifically at the base where the first metacarpal meets the trapezium bone. Also known as basal joint arthroplasty, the goal is to relieve pain, restore thumb motion, and improve grip and pinch strength.

At Katranji Hand Center, we specialize in advanced techniques for thumb CMC arthritis to help patients return to daily activities with less pain and greater function.

Causes

CMC arthroplasty is most often performed due to:

• Osteoarthritis – degeneration of cartilage in the thumb joint, most common in middle-aged and older adults

• Post-traumatic arthritis – following fractures or ligament injuries

• Rheumatoid arthritis – autoimmune inflammation of joints

• Failed prior conservative treatments – such as splinting, steroid injections, and therapy

Signs & Symptoms

Patients with advanced thumb arthritis may experience:

• Pain at the base of the thumb, especially with pinching or gripping

• Swelling or deformity of the joint

• Weakness or loss of grip and pinch strength

• Clicking or grinding sensations

• Difficulty performing tasks like turning keys, opening jars, or buttoning clothes

Diagnosis

At Katranji Hand Center, diagnosis involves:

• Physical examination – checking for tenderness, instability, and joint crepitus

• X-rays – to confirm joint space narrowing, bone spurs, or subluxation

• Assessment of functional limitations – evaluating daily use impact

Early arthritis may be treated non-surgically, but surgery is considered when pain persists despite conservative care.

Treatment Options

Surgical Procedure (CMC Arthroplasty)

Several techniques exist, but a common method used includes:

• Removal of the trapezium bone (trapeziectomy)

• Tendon interposition – placing a tendon (often from the forearm) into the space to cushion the joint

• Suspensionplasty – stabilizing the thumb metacarpal to prevent collapse and maintain alignment

Our surgeons choose the most appropriate method based on the patient's anatomy, functional goals, and occupation.

Recovery & Rehabilitation

• Initial recovery: Thumb is immobilized in a cast or splint for 4–6 weeks

• Therapy phase: Hand therapy begins to restore range of motion and strength

• Full recovery: Typically takes 3 to 6 months, depending on patient age, health, and compliance

Most patients return to normal daily activities with improved comfort and mobility.

Associated Risks

As with any surgery, CMC arthroplasty carries some risks:

• Infection

• Nerve irritation or numbness

• Persistent pain or stiffness

• Implant-related complications (if applicable)

• In rare cases, recurrence of thumb instability

Prognosis

The success rate of CMC arthroplasty is high, with over 90% of patients reporting pain relief and functional improvement. At Katranji Hand Center, our experienced surgeons and tailored rehab programs provide excellent outcomes for those suffering from thumb arthritis.