What is thumb base resurfacing?

Thumb base resurfacing is a surgical procedure designed to relieve pain and restore function in people with arthritis at the base of the thumb, a condition also known as thumb carpometacarpal (CMC) joint arthritis.

Mr Ali Shafighian, esteemed consultant orthopaedic hand and upper limb surgeon, provides an in-depth look at thumb base resurfacing, including when it is recommended, how it is performed, the recovery process, and the expected outcomes.

When is thumb base resurfacing recommended?

Thumb base resurfacing is typically recommended for patients with moderate to severe thumb CMC joint arthritis. Arthritis in this joint often results in persistent pain at the base of the thumb, stiffness, swelling, and reduced thumb mobility, making daily activities, like gripping objects or writing, challenging.

Non-surgical options - such as splinting, anti-inflammatory medications, or corticosteroid injections - may provide temporary relief for thumb CMC joint arthritis. However, if these measures are insufficient, thumb base resurfacing may then be recommended.

How is thumb base resurfacing performed?

Thumb base resurfacing is a joint-preserving surgery that involves removing damaged cartilage and bone from the arthritic joint and replacing them with synthetic or biologic materials.

Your orthopaedic hand surgeon will first make an incision at the base of the thumb to access the damaged joint surfaces. In some cases, the small trapezium bone will also be partially or fully removed.

To resurface the joint surfaces, your surgeon will introduce a biologic graft or a synthetic implant designed to mimic the function of the natural joint. Implants used in thumb base resurfacing are often made of materials like pyrocarbon or metal alloys, which are chosen for their adaptability and durability. If a biologic graft is used, your surgeon will harvest tissue from your own body (such as tendon tissue) to reconstruct the joint.

Lastly, your surgeon will stabilise the reconstructed joint using adjacent soft tissues and close the incision with stitches. The surgery will take 1 to 2 hours and is typically performed under regional anaesthesia, which numbs the arm, to ensure your comfort.

What does recovery involve?

Immediately after thumb base resurfacing, your thumb and wrist will be immobilised in a splint or cast to protect the repaired joint and allow the surgical site to heal. You will need to wear this splint for 4 to 6 weeks, during which you will be asked to avoid heavy lifting or use the hand for strenuous tasks.

Once the splint is removed, you will begin a structured programme of physiotherapy to restore strength, mobility, and function to the thumb. These hand therapy exercises will be tailored to your individual needs, gradually intensifying over the weeks, to help you rebuild fine motor skills and improve your grip strength.

Most patients will resume light activities, such as writing, within 6 weeks. However, full recovery might take up to 6 months to a year.

What results can I expect after thumb base resurfacing?

Thumb base resurfacing is highly effective in relieving pain and restoring functionality to the thumb.

Many patients experience a significant reduction in discomfort, allowing them to return to their daily activities with improved dexterity and strength. One of the primary advantages of this procedure is also its ability to preserve natural thumb range of motion.

In terms of durability, biologic grafts and modern synthetic implants are designed to last for many years. The likelihood of implant failure is low, and revision surgery is rare but possible if issues such as loosening or wear-and-tear occur in the future.

If you are considering thumb base resurfacing, consult with your surgeon to determine if it is the right option for you. Your surgeon will assess your specific needs, guide you through the process, and ensure you receive the best possible care.

If you would like to book an appointment with Mr Ali Shafighian, head on over to his Top Doctors profile today.