DR. DANIEL AEDO MARTÍN · MADRID

Thumb base arthritis

Opening a jar, turning a key or pinching should not make pain the centre of your day.

What it is

Thumb base arthritis affects the trapeziometacarpal joint. Cartilage wear may cause pain and reduced pinch function. X-ray changes alone do not determine the need for surgery.

Symptoms

Turning keys, opening lids and pinching may hurt. Weakness, swelling or a change in the shape of the thumb base can also occur.

Assessment

Examination identifies the painful structure and assesses stability and movement. X-rays show the joint and neighbouring areas. Tendon conditions such as De Quervain’s can cause pain nearby.

Non-surgical treatment

Activity changes, splints and hand therapy may help. Injections and other measures for symptom control can be considered in selected patients. Daily limitations guide decisions.

When surgery is considered

When surgery is indicated, I first consider dual-mobility thumb base replacement if anatomy and bone quality allow. Alternatives include trapeziectomy. Choice is individual; implant risks include dislocation, loosening and further surgery.

Recovery and follow-up

My usual plan after this replacement uses a dressing without rigid immobilisation. Movement and loading depend on stability, associated procedures and recovery. Activities and follow-up are discussed before surgery.

Frequently asked questions

Does everyone need a joint replacement?

No. We first assess whether surgery is needed, then consider which procedure suits the individual.

When can I use force again?

This depends on the operation, recovery and task. Being able to move the thumb does not mean unrestricted loading is safe.

Which thumb replacement do you use?

Dual-mobility thumb base replacement is the first option I consider when surgery is appropriate and anatomy allows. Bone quality or neighbouring joints may favour a different procedure.

Will I need a cast?

My usual plan after this replacement uses a dressing without rigid immobilisation. Associated procedures or specific circumstances may require additional protection.

How long does a thumb implant last?

There is no guaranteed lifespan for an individual implant. Fixation, loading and recovery matter. Follow-up checks for wear, loosening and instability.

Replacement or trapeziectomy?

Both have a role. Choice considers anatomy, hand demands, goals and the advantages and limitations of each procedure.

Exercises: Rizartrosis

An illustrated sheet to follow your clinician’s individual plan. PDF in Spanish.

Download exercises Explore all exercise sheets →

You can also read my Top Doctors article (Spanish): Pain at the base of the thumb: could it be arthritis?