Rhizarthrosis
Overview of the treatment
The most important facts
OP duration: approx. 45 minutes
Anesthesia: regional anesthesia
Splint: Thumb splint for about four weeks
Suitable if...
Pain in the ball of the thumb, loss of strength when gripping, or persistent rubbing noises in the joint are disruptive.
Orthosis and infiltration are no longer sufficient and the symptoms persist permanently.
You want to fully put weight on the thumb again – both at work and in everyday life.
Methods & Variants
Resection-Suspension Arthroplasty (Standard)
The worn-out trapezium bone is removed and the thumb ray is suspended using a strip of the patient's own tendon. This procedure has been established for decades and reliably results in a pain-free, mobile thumb.
Denervation – the minor solution
If only the pain-conducting nerve fibers at the joint are severed, the joint itself is preserved. The procedure is minor and recovery is short – however, it does not work permanently for every patient.
Conservative options
A thumb orthosis relieves the saddle joint, physical therapy strengthens the supporting muscles, and an infiltration can soothe the inflammation. In the early stages, this is often sufficient for years.
When a joint replacement is appropriate
A saddle joint prosthesis may be considered for younger, active patients with a good bone bed. It preserves the length of the thumb, is technically more demanding, and has a limited lifespan.
Which procedure is suitable in individual cases depends on the stage of the arthrosis, the demands placed on the hand, and the bone bed – we will clarify this during a personal consultation.
Process – Step by Step
Diagnosis & Consultation
Rhizarthrosis is first diagnosed clinically: tenderness to pressure over the carpometacarpal joint of the thumb and a positive Grind test are key indicators. An X-ray in two planes confirms the diagnosis and shows how far the wear has progressed.
Preparation
Do not take unnecessary aspirin or ASA ten days before the operation – if there is an important reason, please continue to take it. You can fill out the forms for the medical consultation in advance and bring them with you.
The Procedure
The operation is performed on an outpatient basis, usually under regional anesthesia, and takes about 45 minutes. The worn-out trapezium bone is removed and the thumb is stabilized with an autologous tendon strip. Billing is covered by statutory or private insurance – with no co-payment.
Follow-up Treatment
The thumb is immobilized in a splint for about four weeks. After that, occupational or physical therapy begins with careful movement exercises. The sutures are removed after about two weeks.
Healing process
After two weeks, the sutures are removed and the wound has healed – the splint remains in place.
After four weeks, the splint is removed; office work is then usually possible again.
After three months, powerful gripping in everyday life is also possible again.
After six to twelve months, the grip strength reaches its final level.
Risks & Safety
In the first few days, swelling, bruising, and a feeling of tension are possible; temporary restrictions in movement may occur. Rarely, wound healing disorders or inflammation occur – especially if the hand is subjected to stress too early. Scar discomfort or temporary irritation of the superficial radial nerve are also possible.
We minimize risks through a tissue-sparing, standardized procedure, work in regional anesthesia without anesthesia risk, a custom-fit splint supply, standardized hygiene processes, and close follow-up checks. Wear the splint consistently – this is your most important contribution to the result. In the event of increasing swelling, severe redness, or fever, please contact us immediately.
Diagnostics & Alternatives
X-ray in two planes, hand surgery examination to confirm the diagnosis and stage
Thumb orthosis as a conservative basic treatment
Infiltration to soothe the inflammation – resection-suspension arthroplasty for persistent complaints
Denervation or saddle joint prosthesis as an alternative for selected patients
