Overview
Basal Joint Arthritis & Thumb Carpometacarpal (CMC) Arthritis
Arthritis of the hand and wrist can be particularly painful and debilitating. One of the most common places to experience arthritis in the upper extremity is the thumb joint. This is also known as the carpometacarpal (CMC) joint.
This needs to be sorted out from other conditions but we use a thorough history and physical exam with x-rays to determine whether this is cause of your pain. If it is, then we start with conservative management such as bracing or steroidal injections before moving into surgery. The surgery, while we do routinely, is a last resort for our patients.
Dr. Anup Patel Advantage
Dr. Anup Patel uses a technique to remove the arthritic bone known as the trapezium. To prevent the bone in front known as the metacarpal from falling into the recess, he uses a slip, not the entire, tendon known as the FCR to suspend the metacarpal.
This technique was pioneered by his partner, Dr. George White, then uses the power of bone tunnels to weave the tendon, not once, but twice, into the base of the metacarpal and tighten it down. This provides a unique, powerful suspension that eliminates pain at the thumb joint and enables great range of motion afterwards.
Symptoms
- Pain in the base of the thumb worse with motion
- Stiffness of the thumb
Causes
- Advanced age
- Repeated use of the joints
- Sequelae of traumatic injury
Treatment: Non-Surgical
- Oral medications (anti-inflammatories)
- Steroidal Injection
Treatment: Surgical
- Thumb CMC/Basal Joint Arthroplasty (various techniques individualized for each patient)
Trapezium Technique
Patient 1
65 year old, philanthropist and journalist, female presents with severe left thumb arthritis at the cmc joint. She undergoes our unique thumb arthroplasty with FCR LRTI. She has no pain and full range of motion at 12 weeks.
Patient 2
51 year old, philanthropist and former model, female presents with severe right thumb arthritis at the cmc joint. She undergoes our unique thumb arthroplasty with FCR LRTI. She has no pain and full range of motion at 12 weeks.
Patient 3
62 year old retired lawyer, female presents with severe right thumb arthritis at the cmc joint. She undergoes our unique thumb arthroplasty with FCR LRTI. She has no pain and full range of motion at 12 weeks.
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Dr. Anup Patel
Dr. Anup Patel is a board-certified plastic and reconstructive surgeon trained in aesthetic, hand/upper extremity and reconstructive surgery. He completed his plastic and reconstructive surgery training at the premier Yale University followed by a hand and microsurgery fellowship at the New York University Institute of Reconstructive Plastic Surgery and Mount Sinai Department of Orthopedics. Dr. Patel received his MD and MBA from the Yale University School of Medicine and Yale University School of Management, respectively. He graduated as the valedictorian of his class at the University of Florida majoring in economics, biochemistry and molecular genetics and valedictorian of his high-school class at Lake Highland.
