What is CMC Arthroplasty?
Carpometacarpal (CMC) arthroplasty is a surgical procedure designed to treat arthritis or degeneration of the thumb's basal joint, where the first metacarpal and trapezium bones meet. This joint plays a critical role in thumb movement and function. CMC arthroplasty involves removing the damaged joint and replacing it with a prosthetic implant or using a tendon from another part of the body to restore function and alleviate pain.
When is CMC Arthroplasty Recommended?
CMC arthroplasty is typically recommended when other treatments for thumb arthritis have failed. It may be suggested when:
- Severe pain affects daily activities and is unresponsive to non-surgical treatments.
- Osteoarthritis has caused significant wear and tear on the joint.
- Loss of strength or mobility in the thumb significantly impacts hand function.
- Non-surgical treatments such as bracing, corticosteroid injections, or physical therapy no longer provide relief.
How is CMC Arthroplasty Performed?
CMC arthroplasty is performed under local or general anesthesia. The surgeon makes an incision at the base of the thumb and removes the damaged trapezium bone. In some cases, a tendon from another part of the body, such as the forearm, is used to reconstruct the joint. Alternatively, a prosthetic implant may be inserted to replace the joint. The surgeon will then close the incision with sutures. The procedure typically takes about one to two hours, and patients can usually go home the same day.
Recovery After CMC Arthroplasty
Recovery from CMC arthroplasty generally takes several months. Patients will need to wear a splint or cast for a few weeks to protect the thumb and allow it to heal. Physical therapy may be recommended to improve strength and flexibility. Most individuals can return to light activities after 6-8 weeks, but full recovery can take 3-6 months, depending on the individual’s healing process.
Risks of CMC Arthroplasty
While CMC arthroplasty is generally safe, there are some risks to consider:
- Infection at the surgical site
- Nerve damage or numbness in the thumb
- Stiffness or decreased range of motion
- Blood clots
- Implant failure or dislocation (if a prosthetic is used)
Benefits of CMC Arthroplasty
CMC arthroplasty offers several advantages for patients with severe thumb arthritis:
- Significant pain relief and improved quality of life
- Restoration of thumb function and strength
- Enhanced ability to perform daily tasks such as gripping, writing, and lifting
- Lower risk of complications compared to traditional fusion surgery
- Shorter hospital stay and quicker recovery time compared to open surgery
