Thumb Saddle Joint Arthrosis (Rhizarthrosis): Surgical Therapy

If conservative measures do not lead to the desired success, the following surgical measures can be considered for rhizarthrosis (carthrosis of the thumb saddle joint):

• Resecting arthroplasty (gold standard); in long-term studies, very good to good results have been achieved in 80-95%; the procedure:
  • Resection (removal) of the arthritically altered os trapezium (carpal bone/large polygonal bone).
  • Filling the resulting cavity by means of a tendoplasty (insertion of a tendon bundle).
  • Disadvantage: slightly reduced strength in the thumb.
• Arthrodesis (stiffening surgery).
  • Indication: young patients with heavy load on the hand and finger joints (eg, crafts professions).
  • Contraindication: arthritic changes in the adjacent joints.
  • Advantage: strong load capacity of the joint
  • Disadvantage: poorer mobility of the thumb
• Endoprosthetic replacement of the thumb saddle joint – this procedure has not yet become a standard procedure.