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Thumb Joint Replacement Surgery: Purpose, Procedure, Risks and Recovery

Thumb Joint Replacement Surgery: Purpose, Procedure, Risks and Recovery

Perhaps you’ve just been told you need to have thumb joint replacement surgery, but have no idea what that is, let alone if there are any risks, or what the recovery time looks like.

We sat down with Dr. Ying Chi, an orthopedic hand surgeon at Hoag Orthopedic Institute, to discuss all things thumb joint replacement surgery.

Q: When is thumb joint replacement used?

A: The thumb LRTI joint reconstruction is done in patient with basal joint arthritis of the thumb and debilitating pain which effects the patient's hand function. It is an excellent pain-relieving surgery that does not require fusion of the thumb joint, therefore preserves the thumb motion.

Q: Who’s the ideal candidate?

A: An ideal candidate would be someone with painful arthritis at the thumb basal joint but wants to preserve thumb motion and decrease pain. We do not recommend young patients (younger than 45) who has heavy, manual-type work for this procedure. They are better off with fusion surgery.

Q: How does a typical procedure progress?

A: The procedure involves taking out the arthritic thumb bone (the trapezius), and use the patient's own tissue (the FCR tendon) to reconstruct the joint and create the new joint cushion.

Q: What’s the typical recovery time and is physical therapy part of the usual protocol?

A: The patient typically will be in a small cast that holds the thumb immobile for about six weeks to protect the reconstruction, then out of the cast to start gentle use and participate in once a week therapy for another six weeks. Usually there is complete and normal use of the thumb at three months from surgery.

Q: What risks are associated with the surgery?

A: Risks include tendon injury, vascular injury and possible infection. They are very rare, but the LRTI procedure is quite technically demanding and should only be performed by a board certified and fellowship trained hand surgeon.

Dr. Chi

Ying Chi, M.D