Basal Joint Arthroplasty
When medical and physical therapy are inadequate to treat a severely damaged joint, arthroplasty may be an option. Basically, arthroplasty is known as joint reconstruction or joint replacement surgery, where the diseased joint is typically removed and replaced with a ceramic, plastic, silicone or metal prosthesis.
The drawback of this procedure however is the high incidence of wear of the implants, recurrent pain and instability of the joint and loss of strength. Consequently using prosthetic implants for the basal joint is recommended for older patients who have a relatively low level of functional activity.
For younger patients and more active patients, interpositional arthroplasty using tendon is advisable for the basal joint. This involves the reconstruction of soft tissues like ligaments around the thumb joint and the use of tendon repair to modify the joint space. Arthrodesis or joint fusion may be done in some cases.
After the operation the wrist and the arm are immobilized with a cast until healing occurs. After a few weeks hand and wrist exercises are done to mobilize the joint and strengthen the muscles.
Complications of basal joint arthroplasty include bleeding, infection and nerve damage resulting in weakness of the thumb.
In many cases pain is relieved and mobility is restored by basal joint arthroplasty. However, revisions may be done due to failure of the surgery in some cases. Consequently many other techniques have been developed for reconstructing the basal joint.